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."

Looks like they describe this as a BS/MS program which means you will get your Bachelors and Masters at the same time. It doesn't look like you are accepted to the CRNA program along with that. It just means you'll already have your Masters in Science or Nursing before starting the program. If you have to complete a year of ICU experience first then it's not direct entry. I think what the OP meant was starting a CRNA program directly out of their BSN program without ever having a nursing job. This is available for NP's in some programs but not for CRNA's.

A lot of the things you do in critical care nursing a carried over to the OR during anesthesia, such as using the monitoring equipment, quickly recognizing rhythms, titrating drips, etc.... It takes experience to get proficient with doing these things; you can't just learn them in a book, and they can't be trying to teach you that while they're trying to teach you anesthesia. So no, I don't think it will ever happen. If anything I think the minimum ICU experience required will only increase, but it will probably never decrease.

As long as you have good critical thinking skills then you can handle critical care. From my own experience when I transitioned from med/surg to ICU the biggest change was going from an environment where my main goal was time management to make sure I completed all of my tasks to an environment where critical thinking is paramount. Time management and prioritization is still important but you have to critically think about what is happening with your patients so you can anticipate needed interventions and fix acute problems. Med/surg is more of an observation environment simply due to nurse to patient ratio. The technology is a little more advanced. You have bedside monitors, a-lines, swan-ganz catheters, balloon pumps, crrt machines, ventilators, etc... But you should receive training on these things during your orientation. The drugs are a little different as well. You will be titrating vasoactive medications, sedation, etc... based on your patients' response. This isn't a cut and dry subject, you get good at it by doing it a lot and developing a feel for it. Another big change between floor nursing and ICU nursing is autonomy. As a critical care nurse you'll be expected to have the knowledge to make certain decisions you might not make on the floor and carry out interventions you may feel like you need an order for. This comes with getting to know your intensevist and what they expect you to do in certain situations. You also need to be comfortable with being a team member in a code and may have to run a code. For instance, my hospital is a smaller one and we only have one in house MD available for codes, if there are two codes at the same time an ICU nurse may have to run one of them. Don't let all this scare you off. Most ICU's have an orientation period during which you will learn what you need to know. Larger hospitals even have internships you can do to gain experience in a few different critical care areas before deciding which one you want to practice in. Preparing for you CCRN is a good way to gain the knowledge you'll need for critical care and a good book for that is "PASS CCRN." A good book regarding hemodynamics that is easy to understand for a new learner is "Hemodynamics Made Incredibly Visual." Realize that if you go into critical care and you don't feel comfortable with a situation you have a charge nurse and colleagues that you can collaborate with. It's a learning process but you shouldn't be afraid of going for it.

If the RNC is applicable to your field then it would be good to have to show that you are competent in the nursing you practice. However, there aren't many programs that consider NICU as critical care experience required for admission to school. This is because the program mainly focuses on adults. If there are schools you are already looking at that will accept NICU nurses then you may want to have the CCRN as well just to prove to them you can solve problems related to adults as well.

That wasn't very nice. I think I know what you mean by this and I experienced it a few times as a nursing student. You felt like you were pushed aside and treated as if you weren't part of a team. The reason is probably just because you didn't know anyone nor did you relate to their role in the OR. Like I said I felt the same way the first couple times I went to the OR; people just don't want you to mess up their things if you don't know what you're doing in that environment (such as sterile fields, etc..) After I had been in the OR quite a bit and could let people know I knew what was going on and/or knew people I didn't feel so out of place. It's just an environment you're not used to and felt a little uncomfortable in. Don't sweat it; I'm sure you felt the same way during your first clinical rotation as an RT; or the first time you worked with a vent in front of a patient, or the first time you drew an ABG....

Ditto. There's really no easy road to get done with your classes that I'm aware of. I assume you mean family nurse practitioner. If you go to a program that awards you a MSN with focus in FNP and you then went to nurse anesthesia you probably wouldn't have to take the MSN courses like research, stats, theory, etc... However there are still a lot of heavy courses, you will probably be required to retake A&P, and you'll still have to take all the anesthesia related courses. I don't really think it would help you get done with many classes and you will end up spending much more money. If you want to take some classes to get done then contact the school you intend to go to and ask what classes you can take prior to entering the program. Also bear in mind that if you want to retain your FNP license after CRNA school that you will be completing the continuing education credits for two different specialties.

What was her history besides Pulmonary Fibrosis, why was she being CT'd, and what was her glucose? If she was diabetic she could have been in DKA (probably needed more fluid replacement) - Low BP, hyperkalemia, mental status changes?, respiratory difficulty could have been due to her acidosis (maybe she was trying to compensate then tired out). Also was she on Bipap or CPAP, you said both.

If the incidence of catheter related infection is so high in your facility that you are turning to femoral sticks for blood draws then there needs to be some root cause analysis taking place to find and correct the exact cause of the catheter related infections. Whether it be poor access technique, poor maintenance and care, or poor insertion technique. The incidence should not be that high. In addition, why is the femoral artery being used as an alternative? What's wrong with a simple peripheral venous stick, or if an artery must be used as a last resort, the radial artery? If any arteries are used the radial should be used because it has a backup blood supply to the hand. The brachial and femoral do not have backup blood supplies to their distal tissues. Hence, for those, thrombosis = very bad. Even if the femoral vein is used there will be accidental artery sticks and holding pressure on that artery repeatedly will macerate that artery; try to find a picture of it; it looks horrible. That's the reason they now have closure devices for femoral arteries after sheath use. Aside from that; repeated arterial sticks of any artery are a bad idea for the same destructive reason and any patient that needs it done, such as frequent ABG analysis, should have an A-line. The problem here is with the CVL's and needs to be resolved there. Arterial sticks is a poor selection as an alternative to this problem. Oh yeah, no, RN's don't do femoral sticks at my facility.

LoveHearts, I believe they do have another round of interviews Jan. 5 & 6. At least that's what I was told in my interview. That's why I was surprised to hear from them yesterday. This was my first year applying, the 5 or 6 years thing referred to me finishing up school and getting the experience and requirements I needed to apply. I got on here a lot when I was in nursing school and read other people sharing their acceptances so it's good to be the one doing that now. Good luck! presrna, I interviewed for the Cincinnati area clinical sites. The person that coordinated those interviews is who called me. They told me the school would be contacting me soon. I'm not sure which clinical site I will be at. From what I understand everyone for all the clinical sites were interviewed at St. E's. I imagine I'll find that out when the school contacts me. I'll probably go ahead and call on Monday though and ask her when I should expect to find that out.

I went to Miami Ohio for my undergrad degree. No they don't have a CRNA program. They have no advanced practice programs. But they do have a stellar ADN and BSN; soon to be pure BSN program. Speaking of which, Future_RN, I need to e-mail that pharmacology professor of yours to let her know I got accepted to TWU and thank her for the recommendation.