1RRRN

Is this Borgess, Kalamazoo? Huffman was making mass calling & offering $4400/week.

Thanks for taking the time to answer that. I meant...if I can hear a "thumping" all the way down to complete deflation of the cuff, is the Diastolic really zero?The AHA was saying to count the first "muffling" in the korotkoff sounds. So, the systemic resistance must be low or something else causing the "turbulant" pulsations. I'd see this more in pediatrics than adults. But, the answer was good for another reason. Thanks

Well, now you know something that you didn't know before, Babylover. But, don't take it personally. You could persist in finding out what went wrong. But, the more contacts you have the better. Back to the drawing board. Another idea is to volunteer with an agency that might involve a NICU. March of Dimes? Churches...afgans for tykes? Laleche (?) League, Lamaze (?) instructor. Liaison Outreach nurse for somebody or other non-profit? Premie specialty stuff. Maybe even working business/product nurse rep?Part time Home Care? Public Health Outreach? Any insider at the NICU at all? Informational interview or causal encounter. Something that might give you an idea of what and who is going on related to the field. Contacts, skills and knowledge. Volunteering helps you get your confidence up and they always love to see you! Even volunteer at the hospital you want to get into! Which gets you in the nurse identity role again with something recent to talk about. Anyway, don't lose hope. Someone said something about getting back to yourself....but, really it is getting forward to the next you. It may be something new, related, or the next level up . Or may not be exactly what you have done before. Do not take it personally. You have your own new niche to discover. A professional career coach might have ideas too...usually free at your state employment office. Keep your head up. There is a door for YOU!

What is the clinical significance of korotkoff sounds with blood pressure measurements. Especially, for example, 110/palpation...what is happening to the diastolic measurement? The AHA had a "Off the Cuff" presentation on correct BP methods, including using the bell vs diaphagm to hear. But, I have rarely seen this done. Thanks

Think about all the 44+ million people without coverage. Single payer is DOA now. That would be much more gradual. What if everybody had insurance? Wouldn't that be good. What if insurance was simplified and more standardized? What if all the adminstrative costs dropped like a rock? What if all the information in the world was at your finger tips? What if Doctors and Nurses got control of the system instead of the insurance companies trying to ram people through the production line? What if drug companies had fair prices and fewer side effects? It is going to get better for patients and therefore nurses! But, I wouldn't count on 1000 bed hospitals being there forever.

Oh and steer clear of "Human Resources" if you can. They are not your friends. Get to the hiring manager as quickly as possible. Talk now & future.

Lol....4 kids? I think you know babies! That's good...you've still got humor. But, that's where a little Adult stuff comes in. I'm sure you've heard of Kegel and peri-pads! I did 15 years Pediatrics at Children's hospitals where it was drilled into my head that "kids aren't just little adults". Then I did 2 years of Adult Med/Surg where I heard "the elderly aren't just older adults". Ped's was alot more fun. But, adults can be cool too. YOU know you've got an edge on somebody with all that experience and updates. Why waste time refreshing stuff you never needed before? Just get a wave of energy and confidence going. Try to get a edu proposal in your mind to present and expect SUCCESS!

15 years in NICU is alot of specialized knowledge! I would think you could try talking directly to a NICU about an orientation tailored to you. Maybe even propose a plan that includes CEU's from within the employer & professional associations to get started. It's hard to believe that you would completely forget everything you knew. That much experience is very valuable and you probably got to a level of expert then. Good luck! Skip adults....

Read the user id: In2b8u = In to be "rate" you. Is that your motive Mr.EMT? I also hope your identity becomes public and you are sanctioned.

You can stay where you are to do the MSU program. It is online theory/study with clinical practicums at the hospital or setting in your state. The school works with you to find a preceptorship. But, check out the Sigma Theta Tau site too. That would be recognized widely. I found that it is hard to find a hospital with an existing refresher. But, you might be able to. You could bring these ideas(or others) for study to your future employer. As a conversation starter anyway. Or if you know where you want to work already try to negotiate an orientation that suits you. There is alot that can be done online with specialty ceus. Good luck. Get a mountain of postive energy building in yourself. I've also been able to get extra classes as a Red Cross volunteer. That's one good thing about volunteering...They LOVE to see you! And it helps to get your "identity" back and DO good.

Anyone enrolled or completed the RN refesher online course through MSU? Advise or comments?

Consider addressing the new Lpn directly as teachable moments. She is new and needs mentoring. Since you found things you liked about her before, mix in some positives too. But, there are Safety concerns that need to be discussed. Explain the policies or guidelines, rationales and importance for consistency within the staff. Also, the issue of teamwork and cooperation vs staff splitting. Help her to realize the difficult position she putting you in...that leads to aggravation and frustration for you. Gently framing it in broader discussions of Diabetic management or med admin safety for example, may make it easier for her to accept and feel more secure.

Thanks, "Paradise" for sharing your insight and knowledge. Much appreciated. I'll stay tuned.

http://www.nursingsociety.org/Education/ContinuingEducation/Pages/ceonline.aspx this is Sigma Theta Tau website. Check it out. Also, nursing.msu.edu Michigan State University. On line refresher open to nurses in other states with clinicals in your local area. This has another option to include Ambulatory, Home Care, Long Term care etc...

Thanks everyone for your input. Re. Michigan nurses...what do you know about http://www.residentialhomehealth.com/careers.php? Looks like an agency with alot of perks. But, it was good advise to consider volume and continued clinical support. I like to problem solve and am pretty good at recognizing my resources. I'll be doing clinical practicums at the site of my choosing. The mission statement is going to weigh heavily on my decision. I'd rather have a positive work environment than $. I also like the idea of maybe multiple agencies, once I get going. I think that helps to stay a bit above the fray. Thanks for responding!!! :)