NurseKitten

Take your dialysis experience, go get some ICU, and go to anesthesia school. I was a dialysis nurse for 13 years (chronic and acute, both hemo and PD) and WITH THE ICU EXPERIENCE, my dialysis training has served me EXTREMELY well in anesthesia. The type of monitoring, the flow sheet charting, the machine checks, the airway setup, the drawing of drugs for the next case...your organizational skills gained in dialysis will help you with the work flow as much as anything else. But you need the ICU to teach you the clinical background needed.

The size of the IV speaks to the resistance to flow overall. According to Pouseille's Law, decreasing the diameter of a flow tract by 50% will increase resistance by a factor of 16x's. Resistance in an IV also contributes to turbulent flow, (as opposed to laminar). If trying to infuse quickly through a smaller IV, it increases your chances of infiltration. So you're correct when you say it's not related to the IV itself...directly. But it could be argued that there is an indirect correlation.

I sure don't disagree with the concept of one actually doing the surgery and anesthesia being responsible for the monitoring. Have seen this time and again not only with this concept in dental, but endoscopy, cardiac caths, etc. Have seen too much, too many things happen.

Pay the money to get it expunged, get your records sealed, whatever. Just do it. Work OT, work two jobs, whatever you have to do. It will be money well spent.

It's cheaper than the alternative, which is giving up your life. You get out of it what you put into it. Best of luck.

Excelsior ADN and BSN grad here...now a CRNA. It can happen. You get out of it what you put into it.

If you can't run blood with NS, then I have been doing it wrong in every open heart I have ever provided anesthesia in. Just sayin. Does your hospital have Up To Date or another clinical resource database. I paid the $$ to have UpToDate on my phone and iPad with me in the OR, cause I always have a current evidence-based database with me to answer what I don't know.

All day, every day. But let me say this: while I have literally thousands of intubations...y'all, it's a neat party trick, but knowing how to maintain an airway with chin lifts, jaw thrusts, oral airways, and how to bag someone...THAT'S how you save a life.

I haven't met much I can't tube with a Miller 3. It is my exclusive choice.

My guess is the 90K in Florida is around the Gainesville area. Shands starts in the 90's. One of my friends got a job there straight out of school. She says the money stinks, but the experience is fabulous.

When I left my chronic HD position in 2005, I was making 24/hour in North Florida with 12 years acute/chronic experience and a CNN cert. My friends still there say it hasn't gotten much better since then.

Yes, CRMC pays more. You will earn EVERY PENNY of it.

TMH isn't a bad place, and we always need experienced ICU nurses. If you're not opposed to straight weekends, 31/hour + shift diff. I can't recommend CRMC. I worked too hard for my license.

Haven't seen anybody from the Panhandle, so I'll join in: Pensacola - West Florida is a scary place. My gf just quit as a house supervisor in fear for her license. It is an HCA facility. Sacred Heart and Baptist are both OK. Tallahassee - Tallahassee Memorial is actually not a bad place. I've been in and around several places, and TMH does a lot of things right. Not everything, but a lot of things. Capital Regional...well, let's just say it's an HCA and leave it right there. :-\ To the person who said Gadsden Memorial was shut down over financial - no, it wasn't. The state came in and closed them down. I worked home health over there and arrived to see a patient who had been admitted at the same time the state was literally wheeling patients out and into ambulances for transfer to other facilites. It's reopened under the auspices of Capital Regional - yes, the HCA facility. Ought to be interesting, if nothing else.

You take a deep breath and learn to think outside the box. Sounds like you're doing just fine - we all have those days, and don't let anyone tell you they don't, 'cause they're lying!

If you originally had a Massachusetts license, it didn't expire in this short time. You're just licensed in 2 states, if I understand the situation correctly.

How does she organize her work? I was originally taught to outline my patients by hour and write in the meds, and whatever else I'm going to have to do (blood sugars, temps, IS, etc) by the hour. If she's task-oriented, maybe this would help, if you haven't already done it with her? Give her checklists of "this gets done on every patient, no matter what", "these should be considered for this diagnosis", etc etc etc... I will say, though...before I went to the ICU, I was a clinical preceptor for the local dialysis clinics. I had to tell more than one person that dialysis wasn't for them, and it didn't mean they were a bad person, or a bad nurse, just they weren't cut out for dialysis. They had a lot of the same issues you talk about here.... BUT...there is NO excuse, and I do mean NONE for showing up late, not reporting off when you leave for ANY reason, and not doing your homework. NONE. You are vicariously responsible for her practice, and if you let her off orientation and she screws up...guess who it could come back on?? If she's not doing what you're telling her to do, then she is not hacking it. Period. The end. You sound like a lovely person...wish there were more preceptors like you out there...but I think your gut is right on for this one. She's not cut out for this kind of acuity.

http://www.amazon.com/Lippincotts-Illustrated-Reviews-Pharmacology-4th/dp/0781771552/ref=sr_1_8?ie=UTF8&qid=1307115631&sr=8-8 Saved my BUTT!

Uploaded is a set of notes from my CRNA program regarding neuroanatomy. You'll want to go back to page 36 (?) and read from there - it's all really good neuro ICU info, though...made what I had been doing prior to going to school make MUCH more sense!

Not once on here have I seen the best answer, in my opinion: Go find yourself an administrative law attorney who specializes in healthcare law, and have him/her look at the case law precedents. It may cost you a couple thousand, but it will give you peace of mind to proceed...and should there be an inquiry, you have an established attorney-client relationship to answer the BON's inquiry. They can also help you with whatever statement you disclose to the BON regarding things. NEVER NEVER NEVER go up in front of ANY Board without legal representation, even if you didn't do anything wrong. My attorney literally saved my career.

If you were a successful secretary, then you should have no problem with a physician's office. Much of your workload will hinge on being organized and efficient. It'll take time to learn, but if you have solid assessment skills and an honest love for the job, you'll be fine.

For me, personally, if I were going to be in nursing long-term, nights is where it's at. I've done both - I was straight days in dialysis for 13 years...but when I went to the hospital, I'm all about the nights. Less supervision, more independent thinking, and your coworkers can be your lifeline. Now, I've finished my master's and am going to have to go back to days...part of me is looking forward to it (I can't flip those hours like I used to) and part of me dreads it. You'll find what works for you...and it may not be forever, but if it works for now, that's good enough. That's the beauty of nursing...we have so many options. Blessings to you as you figure it out. :)

Pregnant doesn't mean incapacitated, if it's a healthy pregnancy. You'll have to exercise good judgement, but there's no reason not to go to the interview, and even see if she'll let you do your orientation, to start work proper after the baby's born. Either way, congratulations, best of luck, and God bless.

Right on...I often joked that my training site had more than made a mint off my free labor when I was in clinicals. I'll be interested to see what the MDA's tune is once they have to be in that never-ending lap-converted-open exploratory...

I've kept mine, but have only been a CRNA for 6 months. Not sure if I'll renew it. I do think CRNA's involvement with AACN is important, as we are a good resource to help facilitate deeper understanding of intensive monitoring and physiology.