studley

Are you still interested in the Air Force or another service? There's been a lot of recent changes with the BRAC (Base Relocation and Closures) happening in all the military branches. Here's some more information about where the ICU's are: In the US: Wilford Hall Medical Center (Combining with Brooke Army Medical Center) in San Antonio, TX - This is a joint hospital and clinics, to be re-named as San Antonio Military Medical Center - This is the biggest and most advanced Army/Air Force hospital in the US - This is the only Military Hospital with a Pediatric ICU and a Neonatal ICU. Andrews AFB, Maryland (Combining with Walter-Reid Army Medical Center and Bethesda Naval Regional Medical Center) - In the D.C. Area - Next largest military hospital in the US Elmendorf AFB, Alaska Travis AFB, California - Recently started a new open-heart service Wright-Patterson AFB, Ohio Nellis AFB, Nevada Keesler AFB, Mississippi Eglin AFB, Florida Scott AFB, Illinois Overseas: Technically, the Air Force counts Alaska and Hawaii as overseas, so Elmendorf is an overseas hospital Tripler Army Medical Center, Hawaii This is an Army hospital, but occasionally it gets staffed with Air Force Nurses as well. -Landstuhl Regional Medical Center, Germany A joint Army/Air Force Hospital, currently to be an ICU nurse there, you have to have prior experience as a CCATT Nurse, which is the Critical Care Air Transport Team (litterally a flying ICU) that transports critically ill wounded warriors back to the US from their deployed location, and they provide humanitarian critical care air transport in the U.S., for example, after Hurricane Katrina. If you are coming in new to the Air Force and want Germany, you may be able to negotiate it into your contract, just be sure you have it in writing! - Lakenheath Air Base, England - Misawa Air Base, Japan Not sure if there's still Air Force ICU here or not, may have transitioned to using the local facilities - Kadena Air Base, Japan Naval hosptial, but possible to get stationed there - Osan Air Base, South Korea (this is usually a remote tour for 1 year, meaning you can't bring your family...but if you do it, then you get to pick your base of preference afterwards, so you can go to any base you want guarenteed, ocassionally there are three year accompanied tours here, meaning you can bring your family) These are the only hosptials with ICU's, but there are other places that an ICU nurse can work in the Air Force. There are many leadership opportunities available, nurse manager or commanders. If you're interested in teaching, you could work for any Medical Group in the Education and Training department. Also, you could work at one of the C-STARS programs (Center for Sustainment of Trauma and Readiness Skills). They are programs where other ICU nurses go (who may have been away from the bedside for a while) to get a 4-week intensive experience in trauma as a refresher before deploying. These are located in Baltimore, MD, Cincinatti, OH, and St Louis, MO. The ICU nurse there works 4-5 shifts per month in the civillian hosptial, and also coordinates all the clinical preceptorships for the nurses rotating through for monthly training. Hope this info helps. It may not be an all inclusive list, but it's close. I am an ICU nurse (46N3E) in the Air Force and I'm currently at Wilford Hall Medical Center, transitioning to Brooke Army Medical Center in the next few months. Let me know if you have any other questions! I also have lots of friends in the Army Nurse Corps and I have loved getting to work jointly with the Army, so that wouldn't be a bad option either. I don't know much about the Navy, but it's probably be good too. Good luck, Capt Studley

I appreciate your reply, lamazeteacher, however, I only gave example of the times I do NOT agree with patients. 99% of the time there are no disagreements, and I listen to the patients, answer any questions/concerns they have, and provide their nursing care, and everything goes great! I'm just talking about the few patients that need a little more direction. There are many ways to communicate with them, and if you can start on something you agree with, they are more apt to listen (I agree with you on that). But sometimes you have to tell them something they don't like. I'm glad the Atkins diet worked for you, however, I do not know if you are a 50+ male with HTN, HLD, DM, and admitted to my unit for atypical chest pain. When I asked him to explain the diet to me (even though I've already known about it), in his words he explained that this is one of the most high fat diets. I would not feel like I did my job as a nurse, meant to promote health and prevent future disease, if I did not discuss his current diet choice and his current admission for a possible heart attack.

That's how it feels at my hospital too! We recently have been getting more high acuity patients and lots of staff has been leaving. The more the nurses speak out about the high risk we are putting patient's in and other poor processes we have here, the more we seem to get shut out by our own management!

Well, it's not the field of medicine or customer service...it's nursing. Like Whispera said, it is a caring profession, but that doesn't mean we have to wait on people hand & foot. Sometimes a little "tough love" is better for the patient, like the super needy patient that calls you in to the room to ask you to cover them up with the blanket that is at the foot of their bed. Unless they have a legitamite reason for not being able to reach down to their feet and get that blanket (or do whatever it is they are asking), I explain to them that they need to get their independence back and must be an active participant in their healthcare. I encourage them to do as much for themselves within the realm of patient safety, because when they get out of my unit (a typical med/surg unit) they will be on their own at home. They don't often like my answer, but I am a nurse, not a maid or a waitress, even though I do those things when my job requires it. That is OBSURD that your management has been telling you that even if the patient is wrong you should tell them they are right. What about being tactfully honest with the patient! Isn't it our responsiblity to be honest with the patient, even if they don't like it. My last patient admitted for "atypical chest pain" did not like the lecture I gave him about his current Atkins diet. I also printed some research off the internet for him that I'm sure he didn't like, but it's at least in the best interest of the patient!

I live in Florida and have some of the same problems with working night shift. I work 1800-0600, but we alternate 3 months of days and 3 months of nights. I love days because I am more energetic and feel better all around, so when I go on nights, I already know that my body doesn't adjust well. The first time I was on nights I didn't eat that well and didn't exercise much, and that was the worst. Now here's my routine that helps me feel the best I can while on nights. When I get off work, I unwind and relax for about 30 minutes when I get home, then I go through my bedtime routine, then let the dogs out so they won't wake me later. In my room I have black-out curtains, or I used to nail blankets over the windows, to make it completely dark, and I keep my room cool. I run a fan (and I want to try a waterfall or other sound device) to drown out other noises. I sleep usually from about 0700-1400 or 1500. Sometimes I wake up once during that time to go to the bathroom and let the dogs out. When I'm at work I try to drink a lot of water and to eat a generally healthy diet, with one main meal at work, not constant snacking on junk food. I eat lots of fruits/veggies too, and try to avoid sodas and caffiene, especially no caffiene within 4 hours of bedtime. Then, I also try to exercise 3-5 times per week doing aerobic exercise and yoga. We are allowed to work out at work if the patient care allows it, so sometimes we do workout videos in the patient waiting room, and that energizes us. Hopefully some of that will be helpful to you!