NiteyNite

to the the op.... no it's not mythological. It's tough to get in. I was accepted to two schools this year but that means that 10-15 others were turned down. Not to mention the ones that didn't even get an interview, as well as that just being me; I'm not the only one that was accepted (duh). Point being; a ton of people are turned down every year.

Take a deep breath........ now exhale.... think on the bright side, at least they didn't fall on you.

At least 10 years, 4 months, 18 days, 15 hours, 27 minutes, and 1 second. Oh yeah..........hmmm.....treat your job like a relationship....

IMO the best ICU nurses know their limit and when to ask for help... But everybody's different.

LoveHearts, I let them know on Friday that I wouldn't be attending. I know it's been killing you for a while so I'm glad you got the nod. Congratulations!!

I'm not disagreeing with you. The request should have been honored. But if it's in writing somewhere that it's ok for a student to provide care and it's signed then that's binding. Oral requests are also legally binding; but how is it proved? My point was that although the request should have been honored, it would be incredibly difficult to prove your point in court and would probably be a huge waste of money for the family. Especially given the patient is doing fine. A better course would be to learn from that and request it in writing next time.

I'd pick that battle carefully. Most consents, especially at teaching hospitals also provide permission for students. If the signature is there then that action would go nowhere. Noone can prove speech.

Ours doesn't, it only has enough space to write one name. Your giving consent you your procedure and the judgement to select those to perform certain aspects of it. Our consents list the surgeons name and the associates of his/her choice covers the OR nurses, first assist, any other surgeons that help with the case, and anesthesia. As an example I filled out a consent today for a TEE on a patient, the name on the consent was the cardiologist that ordered the procedure but he doesn't do TEE's so one of his partners (associate) is who performed the procedure. They signed the paper; in court that means they read it, wether they did or not. Gotta read the fine print on everything you sign, healthcare not excluded. Regardless though, the MDA in question shouldn't be leading patients to believe he/she is doing the procedures if that's not the case. They should be explaining the ACT model. I haven't started school yet but so far every OR I've been in, if the CRNA is doing the procedure the CRNA has seen the patient prior to entering the OR. Maybe you are only seeing the MDA see the patient on the floor and the CRNA is seeing the patient in the pre-op area?

He shouldn't lead them to believe he's doing the case if he's not. But if you read the consent form it will probably say. I give permission to "So and So" and/or the associates of his or her choice to perform on "patient's name" "said procedure."

All your boss knows is numbers because that's what she/he has to report to administration. So unless there is some research which shows this is the better way to go and can either reduce length of stay thus saving money or increase patient satisfaction thus increasing the amount of hospital customers and ultimately hospital revenue then nothing will probably change. Everything boils down to money and unless the books can be affected then nothing will probably change. I think it's sad that money is the bottom line rather than patient safety or nurse satisfaction but it's the truth and something we have to deal with.

On the question of certification yes. I am one of the PICC nurses at our facility and we are certified by an instructor from the nurse infusion society that was sent to us by BARD. We use the Power PICC and it's ok to use this PICC for a VAMP or CVP monitoring as long as it's a true PICC, you cant use it if it's a midline or mid-axillary line; that will be specified by your PICC nurse after insertion. Don't use the purple power port for CVP as it has a valve in it. Any of the others are fine and there is no distal/proximal/etc... they all terminate at the same point. On the statement about not normally using VAMPs on the step down unit, I say just go get one from the unit or from central supply along with a pressure bag and use it. You don't have to hook up the transducer to use the VAMP and the comfort to the patient is worth the cost. If you don't normally use them, then have one of the unit nurses help you hook it up for the first time. No big deal, just need to make sure there's no air in the saline bag.

I'm a night shift charge and I take a full assignment. In fact, we've got a lot of new nurses right now so I end up taking the sickest patients a lot of times. On days the charge does not take an assignment, helps out around the unit, responds to codes, rapid responses, bed meetings, etc... 18 bed unit. Our boss tends to do all of her budget savings on nights, we don't even have a secretary on nights...... Total BS, but it won't ever change and I don't have to deal with it much longer.

I wouldn't waste 10mL of blood every two hours..... Hook up a Vamp, it takes two minutes.

Get the CCRN and go for it. Just make sure you understand the CCRN material and apply it to your practice rather than just knowing it to pass a test. Do that and your golden. Have you taken the GRE? Don't forget you need to do that as well for most programs.

Check out www.aana.com as well. That's the national body for CRNA's and there is a lot of good information there such as what CRNA's do, what their scope of practice is, how to be one, etc.... There's a drop down menu on the left I believe it says "becoming a CRNA."