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valx92

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valx92's Latest Activity

  1. valx92

    Thomas Jefferson 2020

    I know for other schools they look at the GRE, but I went to an info session for Jefferson over the summer and I asked about it and they said they don’t look at it. So it might help you elsewhere, but if you’re thinking of this school in particular I wouldn’t bother !! 🙂
  2. valx92

    Thomas Jefferson 2020

    I applied in early November, I received an interview Dec 9th but I was out of the country so I deferred it to the next interview date which is this Monday, hope that doesn't hurt me. When I scheduled my interview there were more dates in January so maybe they're still looking to send out interviews for those dates. They're still accepting applications until February so I cant imagine they're done interviewing yet !!
  3. valx92

    DKA/HHNK

    Hello all, I work in a medical ICU in a primarily cardiac hospital. It is rare we see patients in HHNK but it does happen. Most recently, a patient was admitted at 4 am and not initiated on fluids until day shift arrived at 7 am. Of course there is a knowledge gap that will be addressed, but I am just wondering if other hospitals have a DKA or HHNK protocol or policy place, and if it is something we should be looking to initiate in our ICU so this does not happen again. Thanks 🙂
  4. valx92

    Lowest bicarb on abg

    “Undetectable.” Guy’s ph was 6.5 and blood sugar was 11. He somehow managed to survive another 12 hours. Only 23 years old 😞
  5. valx92

    University of Maryland CRNA 2020

    Did anyone upload “additional documents”? Not really sure what kind of thing schools are looking for there
  6. valx92

    Childcare & STEMI Call Question...

    My boyfriend is a cardiologist who frequently takes call in the ICU. He just doesn’t schedule himself for call on days he has his daughter. If they try to schedule him, he just says no. His mom and I both help out a lot as well. I think once you have kids, you’ll find a way to make your job work around your family.
  7. valx92

    Flash Pulmonary Edema after Blood Transfusion

    We usually give blood while the patient is on dialysis. That may have helped. Or a dose of lasix or bumex immediately following transfusion if she is still making urine. Hard to say based on this info.
  8. valx92

    Volunteering?

    Hello! I am currently a bedside nurse who is interested in getting into the legal side of nursing; however, I don't want to envelope myself into a part of nursing that I wouldn't enjoy or thrive in. I feel like ultimately I want to get into the politics of healthcare reform, so I am considering going back to school for my law degree. So, my question is, what kind of positions could I volunteer for in order to be certain that this is the type of work I would like to do? Any advice would be greatly appreciated.
  9. valx92

    new grad need some advice

    I recommend Basic and Bedside Electrocardiography by Romulo Baltazar. One of the docs gave this to me when I said I was interested in getting better at reading 12 leads. I read mine all the time it makes 12 leads interesting and understandable. I've gotten pretty good and I've even been able to teach a thing or two to the nurses who have been at my hospital for much longer than I have because of things I learned in this book. But depends on how interested you are to find how much you'll read and how easily you'll pick it up I think!!
  10. valx92

    Telemetry Nursing Questions

    1. If a patient exhibits say a 10 beat run or less of vtach overnight and already has labs for the morning, should I wake up the cardiologist or primary doctor if they don't have a cardiology consult to let them know? if they don't have labs, should I still call if the patient is asymptomatic or can this wait until the morning? Some hospitals have policies for this, but at my hospital it's more of a use your judgment kind of thing. Generally we already know that the patient is having these runs of VT and that's why they're in the hospital anyway. So if the patient's asymptomatic, it can probably wait til morning. I might ask to have their morning labs drawn early if I'm really concerned and then go from there based on what the labs show. Or if the patient is having consistent runs of VT and there's no known history of it, I'll probably go get a pressure to see if it's worth waking up the doc over. Either way I'd say check on your patient and give the doc a call in the morning just to let him know what was going on. 2. If a patient is on isolation precautions, how do I maintain safety from transmission of diseases when the patient is going for a test. obviously with airborne I would put a mask on the patient, but what about if they are contact or droplet and have to go for a test or procedure? Pretty sure there are different policies at different hospitals for this too. Our patients have to put on a clean gown before they leave the room, and anything they touch gets wiped down really well. If it's airborne they have to wear a mask when they leave the room too. That's about it. 3. If a patient had surgery or a procedure and it is in the middle of the night and they start having profuse bleeding, would I call a rapid response to get a doctor right away rather than the surgeon? Depends on what kind of surgery/procedure it is and what's going on. Did they have a cath and now they're bleeding from the groin but otherwise stable? I'd apply pressure and call the doc. Did they have a cath start bleeding from the groin and now SOB low spo2 with a pressure of 60/30? Call the RRT. Same thing with a surgical patient. Just depends on how stable they are really. If it can wait for you to call the surgeon, call the surgeon. If the patient's critical, call the RRT. 4. HIPAA-How exactly should we be handling phone calls in order to maintain HIPAA? For example, if a patient is from another facility like a nursing home or group home and the nurse for the night calls to ask for an update, what exactly can I tell them without breaking HIPAA? Is discussing test results or medication the patient is on and any change in their status breaking hipaa? At my hospital they have to sign a release stating who can get information, so if they came in from a nursing home, we ask if it's OK. But in such a case, they're usually going to return to the nursing home anyway, so for continuum of care purposes, it's pretty important for the people at the nursing home to understand what's going on so we encourage the facility to be added to the list. I've never had anyone say their nursing home can't get information. 5. if a patient is scheduled for surgery and is NPO, should you give any insulin coverage if they have a "high" blood sugar for their accucheck , or not because they are NPO and will not be eating anything? At my hospital our parameters say hold the metered dose and give the sliding scale coverage for NPO. If I know this patient pretty well and I was concerned about the patient's sugar dropping too low with the ordered sliding scale dose, I'd probably hold both and let the doc know what I was doing. We aren't supposed to hold basal insulin for NPO either, but sometimes, again, if I know the patient tends to drop when they're NPO I'd discuss it with the doc and maybe decrease the Lantus dose. I'd never hold/decrease an insulin dose without discussing it with the doc first though. 6. When giving meds for a patient on a kangaroo pump, do I hold the feeding, disconnect the feed, administer the medications by pushing them into the tube, and then flushing and reconnecting and restarting the feed? I will ask to see a demonstration before having a patient with a feeding tube, I just wanted to have a better idea before I started. Yes.
  11. valx92

    Acute Care NP??

    Hi all, looking for a little advice. I graduated with my BSN in May 2014 and I have been at my first job on a cardiac step-down unit since November 2014. I want to further my education, and my end-goal is to work as an NP in a hospital with a focus in eps/cardiology. Since I've only been out of school for just over a year now, some of the adult-gerontological acute care nurse practitioner programs seem like a bit of a stretch for me to get into. I'm going to apply wherever I can, but I'm worried I won't get in without two years of experience, a CCRN, or having worked in an ICU. I submitted an application for transition into my hospital's MICU, but the rest I can't really do much about for another year. I don't really want to wait to apply until next year, because I'm just worried that the longer I wait, that life will take over and it will get harder to return to school. Would I be better off applying to a school for adult-gerontological primary care nurse practitioner and making the transition with a post-master's certificate later? Am I better off waiting another year to apply? Also, why does it seem like at some schools the acute care NP programs are an MSN, and at other schools they're DNP degrees. Am I missing something? Any help or advance would be appreciated. Thanks in advance :)
  12. valx92

    How to become a neonatal np?

    I understand why it would be worrying that I wrote that I want to be an NNP! ...what do they do? But that isn't exactly how I meant it. I knew a general of what an NNP does, but I was looking for more of a day in the life of kind thing. I did find a thread on that, and I am sure that I want to be in the NICU, but now I'm not so sure about taking the NP route. It might be enough for me to be an RN. I do understand your concern that it might be better for me to be a physicians assisstant, and I do know one (not one in the NICU, but still a PA) so I might talk to her about whether she thinks it's the right choice for me, because she knows me better than any of you. I'm not trying to say that any of you are wrong, I'm just saying she'll know better what's right for me. I am glad for all the of the different points of view and this conversation is really interesting; so if you have more to say on the subject, by all means go ahead.:)
  13. valx92

    How to become a neonatal np?

    Thankyou! But, why would you choose to get a degree then go to nursing school when you could just flat out get a nursing degree? Just getting your nursing degree would be faster right? Does doing it the longer route do anything better for you, or is it the same either way?
  14. valx92

    How to become a neonatal np?

    Hi! So i'm a high school junior and it's time for me to start looking at colleges and know what I want to do. Ultimately, I want to be a neonatal nurse practitioner. So I've been trying to research it and I'm really confused. I was wondering if anyone could tell me what exactly you have to do to become a neonatal np and then what exactly you do as a neonatal np? Thanks.