sparkyRN

I am finishing my second semester in the UWYO MSN nurse educator option. I can't speak to the undergrad experience since I got by BSN the traditional way from the Univ. of TN many, many moons ago. But , I do think the graduate program is high quality and reasonably priced. The instructors I've had so far have been engaged with the students online and give good feedback.

I just finished my first class online with UWyo. I'm in the MSN Nurse Educator option which is all online. It is definitely grad level classes which means a lot of reading and analysis on your own then online postings with your classmates. The instructors guide the discussion, but the students give most of the input. It has been a great experience! I've enjoyed virtually meeting my classmates--most are from WY but there are several of us scattered all over the US. It requires commitment, but has been worth it so far. Tuition is the best part...my 3 hour class cost $597 total ($199/hr). The cost is the same in-state or out-of-state making it affordable to pay-as-you-go. The program can be done in 2,3, or 4 years and you have 6 years to graduate. Their website is ok, a little hard to navigate, but the people in the nursing school admin. have been very nice to work with.

There's ideal and then there's reality. Ours is a level 3 referral, 80 bed unit-usually 20 ICU, 40-50 level 2/special care babies. We often carry 3:1 and even occas. 4:1 in ICU, and 5-7:1 in level 2. We'd love to maintain a 2:1, 3:1, and 4:1 standard bu there just are not enough nurses available. The nursing shortage is a real problem for us because we're in a large medical community so lots of competition for the same small group of applicants. You just have to make do, support each other, don't let nurses become "black clouds" in your unit. They will drive people away faster than any bad assignment will. Step up and be a preceptor to the new hires and remain a mentor to them when they are on their own. That's how we've managed to survive for years. We are nurses for our babies first, for each other second and for ourselves last.

The March of Dimes has some great resource material that may be what you need. http://www.marchofdimes.org

Best of luck to you and your husband!

So late in sending you my congratulations...my apologies. Glad to hear the 2nd trimester is looking up! I hope you'll be able to enjoy the rest of your pregnancy. Well, I don't think any of us really enjoy those last couple of weeks! Take care of yourself. Sparky

I'd suggest you save your money right now. It's just one more thing to keep up with. Nearly all the info you will need will be on your unit. It may take a little more time to look drugs and lab values up the old fashion way, but you may be more likely to remember them if you don't have a gadget to fall back on. As mentioned before, nearly everything can be found on the internet too. That's just my opinion, but I am sort of a dinosaur!

You might want to consider the pediatric route. Most children's hospitals, in addition to having a NICU also have a Special Care Unit that is designed for babies past the NICU stage...usually under 1 to 1 1/2 years old. However, you need to be aware that most RN's are not hired into these areas right out of nursing school. Your chances will be better if you work as an extern at a pedi hospital during your last year of school.

Have you toured Carrell Children's Hospital at Vandy? I drove up for a one day nursing seminar and the best part of the day was touring the NICU. It was totally state-of-the-art and much different from the one big room NICU that I am used to. The first think that struck me was how quiet it was. The nurses said it took some getting used to having each baby in their own room and not being able to see all your co-workers because of the way the unit is divided into pods with several hallways dividing them up. Then there is a NICU admit nursery in the old hospital where L&D is. My understanding was that the nurses were assigned to both areas as well as a step down nursery on the other end of the floor. They seemed very well equipped, were pretty well staffed and are always busy as the regional referral center and as a major pediatric cardiac surgery center.

I like most anything ICUish. My favorite is the term PPHN with all the gizmos--NO, oscillator, drips, multiple lines. (Can do without the chest tubes, though.) They are such a great challenge and can have quite a miraculous turn around. It's great to be there for that!

Our situation is a lot like Gompers. I don't mind doing my time in step-down--sometimes the change of pace is nice, and you have to give the newbies some ICU experience so they can work on their skills. I always get a little stir crazy after a couple of weeks there though. It's always good to let the charge nurse know when you need a change. If I'm starting my week and I'm not in ICU, I'll check the schedule to see who's in ICU that won't be back and I'll ask for their assignment for the next day. Also, we use a highlighter to mark the days we are in step-down or isolation so the charge nurse can see who needs to do their turn there.

We are allowed bands, but no watches. I try not to wear the band either because I find all the handwashing to be so irritating and it becomes increasingly so with jewelry on....probably due to the extra moisture under the band.

Tell me what it is...maybe we are doing them, but calling them something else.

Thanks for the encouragement and Happy New Year! Sparky

I agree with Gompers. Besides the learning curve, the chances are better than good that you will be spending a lot of hours on your feet. There's alot of moving to be done in a NICU not to mention trips to L&D, CT lab, surgery etc. When you start in a NICU there should be classroom and discussion time away from the unit. In otherwords, time to sit! Also when you start, you will have a small assignment and will be working with a preceptor. You tend to stay in one spot to start with. IMO I wouldn't combine the stress of being post-op myself and trying to remember everything I learned 3 months earlier.

Where in the scalp did you stick? I know some nurses like to stick the jugulars, but there is no way I'm going there!

We do 2 successfully with a trained nurse then we are on our own. We use the Bard 24G catheter. I work exclusively NICU so, no adults. I am not familiar with 'Modified Seldinger,' and no usg. My 2 attempts on 2 seperate babies were right and left axilla. The first baby weighed about 750gms and the other 600 gms. I think I could do well inserting in the antecubital, but was warned that these are difficult to thread. I did not try antecub on either of these babes because they were both blown. Would there be an advantage for me starting with a little bigger baby and working my way down? I was able to hit the vein, but I found holding the arm in position and stretching the skin taut, but not too tight to be hard.

I was recently placed on the PICC line team and had my bedside training--see one, do one! Actually, the nurses who are skilled at PICC insertion have been very helpful and are willing to assist me as I learn the procedure. I have tried twice and was unsuccessful both times and am now getting a little gun-shy. I can start a peripheral IV in just about any size baby at any level of acuity so I know the ability is there. I just hate failing! Any words of wisdom, suggestions, resources, or stories to make me feel better? I sure could use them right now! Sparky

Totally agree with rainbows. While it's not the preferred or best form of stimulation, if your hands are dirty a thump on the isolette will create a startle relfex and a deep inspiration. If my hands are dirty and the ABD is severe, I'll thump the isolette with my elbow and grab a can of alcohol foam. Even if the baby takes just one breath, it buys those few extra seconds to get my hands clean so I can deal with the baby.

7-8 average though there have been plenty of 10s lately! The stress is either due to high acuity or high census. We actually went on diversion last week for the first time ever because we were swamped.

20 1/2 years

Yikes!

Any good hospital with an established training and preceptor program would probably be happy to have an experienced licensed nurse regardless of his or her background. If you're willing to stick it out, they will likely welcome you with open arms and train you to fit their needs. You might benefit from subscribing to an adult-geared nursing journal to help you keep up your knowledge base.

0.6cc 1/4ns flushes before and after every med.

It is confusing to us too! I'll try to explain...hopefully it will help. In the U.S., there are two entry levels for licensed nurses. They are separate programs. One is the LPN (or LVN--licensed practical nurse/licensed vocational nurse, different name for the same thing). An LPN receives training for, I believe, 18 months then can take a licensing exam. LPNs work most often in doctors' offices, nursing homes and hospital med-surg floors. Their scope of practice can vary from state to state. They can assess pts, give PO and IM meds and chart. They are supervised by RNs. Registered Nurses are also licensed by their state after graduating from either a diploma program (not many of these left, but they do exist; usually a 3 year program), an associate degree program (2-2.5 years of college level training) or a bachelor program (BSN- bachelor of science in nursing, 4 year college program.) RNs do all aspects of patient care; administer all forms of medication; initiate and maintain a patient careplan; do all discharge teaching, etc. RNs work in all areas of nursing. Those who work in critical care areas-ICU, ER, Trauma, burn, receive additional training given by their workplace and often taught by RNs. To be in a supervising role such as nurse manager, a BSN is usually required. If an RN wants to increase his/her scope of practice, then it is necessary to continue in graduate school and receive a MSN-masters of science in nursing. This degree can be in numerous specialties, usually falling under one of four catagories: med-surg, psych, pediatrics and maternal/child. An MSN degree can be in education which leads to teaching in an undergraduate program or hospital based training, or it can be geared toward becoming a nurse practitioner. A nurse practitioner, once he/she graduates from their grad program, then sits for a national licensing exam that allows them to work in conjunction with or under the direction of an MD--depends upon where you are and what you do. A nurse practitioner is also referred to as an APN=advanced practice nurse. There is also NNP=neonatal nurse practitioner, PNP=pediatric NP, etc. There are also doctorate programs. With a doctorate in nursing practice-DNP, there are opportunities to teach at the graduate level. Some programs require an MS first, others accept students with their BSN. Nearly all degrees after the BSN require a minimum of 2 years of full time work experience before entering grad school. There are also certification programs that RNs with experience can take. The initials after a person's name will indicate if they have this specialization. One you mentioned, CLNC is certified legal nurse consultant. The other ones I do not know. Hope this helped. Sparky