fins

I'll leave the discussions about whether the BSN improves one's abilities as a nurse for others. Let me just talk about the job market. There is currently a push to go to all-BSN by (I believe) 2015 in several states. In the northeast, I know that New Jersey and New York are talking about it. So, if this legislation comes to pass (a big if) then entire states would be closed off to you without a BSN. In addition to legislative and/or BON initiatives, there is the magnet issue. Rightly or wrongly, many hospitals have come to the conclusion that their chances of achieving magnet designation are improved by having an all-BSN staff. In Philly, for example, several of the large systems will no longer hire ASNs, primarily because of the magnet issue. Some are telling their current ASNs that they have a fixed amount of time to earn a BSN in order to keep their jobs. Magnet is something the hospital can market, and marketing means money, and if you get between a hospital and its money you will get steamrolled. Now they can get away with all of this during the recession, because so many nurses have delayed retirement, or picked up more hours because of a spouse's employment difficulties. When the job market picks up, and those spouses get rehired, so those nurses decide they can go back to part time hours, those hospitals are going to be staring into the face of another nursing shortage. It will be made all the worse by the fact that entire class years of nursing school graduates have given up finding work and left nursing. Whether the hospitals will still be able to insist on all-BSN hiring at that point is arguable. Presumably, the big, well regarded systems will still be able to do so, but the smaller community hospitals might not be able to pull it off. So what it boils down to is this: there is no place on earth that will hire an ASN but not hire a BSN, but there are quite a few places that will hire a BSN but not hire an ASN. So just from a job availability perspective there's value in the BSN. How much value probably varies a lot by geographic area (in a lot of the northeast not having a BSN can be a real liability, while in Texas that may or may not be the case.) So whether or not the BSN makes you a better nurse, it makes you a more employable nurse. And that's a big deal right now, when even the BSN graduates are having trouble finding work.

Maybe when you said "for years" she thought you said "four years" and now she's mad because you hid two years experience from her. :) Either that, or she just needs to get the stick out of her butt and get over herself.

And when the pool dries up, because nobody wants to put up with being treated that way, the "oi, thingy" nurses will be the ones whining loudest about not having enough staff.

Sometimes, those questions aren't to bust your buns. Sometimes the ICU nurse is trying to see if there's a reason that something wasn't done, e.g. "he needs a CTA but he's allergic to IV dye, so he's going to need to be prepped first." Sometimes it is just whining, but not always.

Please tell me you work on a pediatric unit :)

This has been such a great thread - you hardly notice the poor grammar at all! :) To the poster whose review included the comment "doesn't polish her shoe laces" that seems to me more like the sort of insult that's really a compliment. ("He sings too loud in church" is how my father puts it for people who are genuinely wonderful.) Your manager may have been thinking "I've got to put SOMETHING in here if it kills me."

Take her list, blow your nose in it, smile sweetly and say "thank you."

Although tasering sounds barbaric, is it actually worse then the alternatives? If a patient is out of control, the most likely alternative to tasering is a big hairy furball of a scrum - five staff members or so trying to get restraints on an out of control patient. Not only is the risk to staff exponentially higher, there is also a higher risk to the patient himself. Tasers weren't invented and popularized because it's fun to watch someone twitch. It's because they are generally safer and more effective than alternatives. Also, I am completely unsurprised that a patient with B/L PEs would be so out of control. Even mild hypoxia can have profound behavioral effects. Nothing puts the body into full-bore fight-or-flight mode like the brain thinking that it's dying.

My sister got a traditional ASN. Two years, two semesters per year, 14 weeks per semester, 16 hours clinical per week. I got an accelerated BSN. One year, four quarters, 12 weeks per quarter, 24 hours clinical per week. I actually had more clinical hours than most traditional programs. What I didn't have was summer off, or a long Christmas break. We got one week off between quarters - that's the big difference between the accelerated programs and the traditional programs. I had to leave class on Friday, drive 300 miles, get married on Saturday, drive 300 miles on Sunday, and start final exams on Monday. These programs aren't pared down versions of the traditional nursing programs. The only things pared down were time off (and my honeymoon.)

One possible reason for not using the word no would only apply to written charting, and that is the fact that "no" is such a small word. When you have people whose handwriting looks like they use their elbows to write, "absence of" gives you more of a fighting chance than "no." We've all had those "what does this say" chart parties. "Hey, Lisa! Does this say 'no BM' or '10 BM' ?"

Cargo pants are good - they're basically khakis that have pockets mid-thigh in addition to the standard two front, two back. Some places would consider them too casual, though.

The way the NCLEX works, 265 questions is no more likely to pass or fail than any other number of questions. If the test stops after 85 questions, it means that the test only needed that many questions to determine if you passed or failed. Basically, you either did really really well or really really badly. If it asked you 265 questions, it means that it had to ask all of its questions, because you were right on the borderline. You might have just barely passed, or you might have just barely failed. But still, even if you failed, it's a whole lot better to fail at 265 than to fail at 100. If you get to 265 questions, it means that (at worst) you were very very close to passing. And hey - you have just as much chance that you passed. If you REALLY screwed up, the test would have shut down a lot sooner.

I work in a neuro ICU - when people ask me health questions, I just tell them "let me drill a hole in your skull and stick a tube in your brain - then I'll be able to tell you exactly what's wrong." Oddly enough, I haven't had any takers yet.

The Lehigh Valley Health System has job postings for GNs. That's in Allentown, about an hour north of the city. Also, think about government jobs - not just the military. The VA always seems to be hiring. The process takes a while, but it's an option.

You really really don't want to be caught lying about this. Such minor drug use is not going to be an issue, but if during some security clearance investigation they find out you lied about it, you will be bounced out of the service in a heartbeat. I had a history of teenage marijuana use, and I admitted it. I was still able to get into and graduate from the Naval Academy, get into submarines, and receive a top secret security clearance. Your usage history is well within the "experimentation" limits. It's not even going to raise an eyebrow.

I'm going to have to ask one of the moderators to close this thread and remove it from the web site. It is completely unacceptable that the original poster would bring up this subject. Have you no compassion whatsoever for us male nurses? If too many people read this thread, we'll lose our floor show!

One other thing to consider is that time just flies in a code (sometimes.) You look down, and although it seems like you haven't done anything but two rounds of compressions, when you look up an hour has gone by. An hour-long code can seem like the blink of an eye.

It's a pointless thing to try to attempt. The term nurse has female connotations because well over 90% of nurses ARE women. ANY term you use for a job that is 90% female is going to end up with those connotations. I don't care if you change the name from nurse to "hemi-powered, semi-automatic, laser-guided health missile," if you then attach it to a profession that is overwhelmingly women, then when someone sees you walk into their hospital room, you're going to hear "oh, so you're a MALE hemi-powered, semi-automatic, laser-guided health missile." Language can have SOME impact on perception, but it can't obliterate it. Calling me gravitationally challenged instead of fat doesn't make me look any better in a Speedo. If you got everyone in the country to agree to start calling heavily armed psychopaths "fluffy love bunnies," then people are going to start being afraid of fluffy love bunnies. Nurse is only going to stop being considered primarily a female term when it stops being overwhelmingly a female profession.

I've done post-mortem care on others, but for some reason I've never been able to do it to myself.

With regards to the administration's proposal to make military members pay for service-related care with their private insurance, here's a link. (From that well-known rabid right-wing new source CNN) http://www.cnn.com/2009/POLITICS/03/10/veterans.health.insurance/ WASHINGTON (CNN) -- Veterans Affairs Secretary Eric Shinseki confirmed Tuesday that the Obama administration is considering a controversial plan to make veterans pay for treatment of service-related injuries with private insurance. Lawmakers say they'd reject a proposal to make veterans pay for treatment of war wounds with private insurance.

I had a patient on the ventilator, who was on continuous tube feeds. She hadn't had a bowel movement in three or four days. So a couple of hours into my shift, she has a small bm. I turn her on her side, and she starts coughing, bucking the vent. Of course, with each cough, she shoots out another 8oz of just-too-thick-for-a-rectal-tube poop. Now what made it disgusting was that it was also a very heavy flow day for her period. So I had this (seemingly) unending cycle of: cough, poop, placenta, cough, poop, placenta, cough, poop, placenta....

You WERE being difficult. You failed a driver who deserved to fail, and now the owner has to find another driver - that's difficult. You failed a driver that now needs to find another job, and THAT'S difficult. But do you want to know what would be REALLY difficult? Living with yourself if that driver plowed into a minivan with a family inside it. So to the owner saying that you were being difficult, I'd say..."tough."

I work for a university health system that offers free tuition to dependents. The thing is, the IRS considers that free tuition to be income, so you have to pay income tax on it. So, depending on the cost of the school, that free tuition can be pretty darn expensive. It would actually be cheaper for me to pay to send my kids to a state school, then to send them to my employer for "free" because of the tax hit. Of course, my oldest is 4, so I've got some time before it becomes an issue.

the physiology of blood pressure consists of two main components: cardiac output heart rate - beats per minute stroke volume - amount of blood pumped per beat [*]peripheral resistance - resistance of the arteries against the flow of blood through them increasing any one of the above factors increases the blood pressure and vice versa. when the blood pressure is abnormal, any of the above factors is involved. you're right when you say that when the blood pressure is abnormal, any of the above factors is involved. so, if the bp is low, it could be because the cardiac output is low. but, it could also be because the peripheral resistance is low, while the cardiac output remains normal. so you absolutely can have a low bp without a decreased cardiac output. i was specifically thinking about sepsis. as the previous poster pointed out, in the early stages of sepsis, you can have a drop in bp and yet have an increased cardiac output - the decrease in resistance being more than enough to offset the increase in co, with a net result of decreased blood pressure. i wasn't trying to say that low co won't cause low bp - it certainly will. i'm saying that you can have low bp without decreased co being the cause.

Low blood pressure does not automatically imply decreased cardiac output. It could also be caused by decreased systemic vascular resistance (SVR), without a decrease in cardiac output. And even if the low BP does lead to decreased CO, it doesn't necessarily follow that there's decreased contractility. The decrease in CO could be due to decrease in preload.