4Pack

I'm currently studying - I don't think NPs anywhere in the state of Iowa are doing anything invasive - not that I've heard. And certainly not where I currently work, which is a teaching hospital. I am going to graduate not knowing how to do any of these things, I am afraid.

I have been the attendant at so many deaths lately it is starting to weigh on me a little bit. I've been stuck with this imagery for a few months now and want to share it to unload a little. For background I am an adult ICU nurse. I do not attend the deaths of littles. At the end of life every body I look down upon in the bed I picture as a babe in some mother's arms or a little kid again. At the end of life it all looks like a seamless, backwards to forwards and backwards again progression through the lifestages. So weird. Anyway, thank you for letting me share. I stand in the middle of the room A navy blue badge-wearing Christo Redentor The boy lying at the precipice A thin line between here and not here Behind a closed curtain around a hospital bed Like an old vinyl change purse The sort my grandpa handed out for loose coins I open and shafts of light shoot forth Pieces lost to the family standing vigil over the boy I do this willingly and I have no choice The weight threatens to put me on my knees so I stand White socks poking through rubbed away toes As the boy in the bed opens his mouth at last A slow quiet stream of Charon's air slips by The vigil is ended and I open the curtain

It is feasible - right now we don't own a home and in theory my husband's employer would allow him to work remotely. It would be tricky, but do-able if the pay was worthwhile (over $80k annually)

I am a current ICU nurse and love my bedside work. I am 43 years old and have 4 small children and a husband with a steady job. I know I want to go on to advance practice nursing, and I had thought I wanted to work in an ICU setting or ER setting. I have an application pending for Allen College Acute Care NP program for this fall. However, apparently the hospitals in this area do NOT use NPs in ICU or the ER. Then I was talking to a friend who is currently in a family NP program. She recommended going the family NP route. She said you can always work in-patient or ER with the FNP, but you couldn't work outpatient with Acute care. Outpatient seems to be where NP jobs are around here. so, I need some advice and direction sonIncan make some decisions. 1.) Do I stick with Acute care NP? The impact of doing so would be: *I would likely have to move to get a job in an inpatient setting *I could also obtain a FNP certification after graduation. Keep in mind I'm 43 years old... 2.) Do I switch to the FNP program? The impact of doing so would be: *In this scenario, my application is likely to be delayed because it is the more popular program *I am guaranteed to work in an outpatient capacity unless *I could then get an acute care certificate. Keep in mind I'm 43 years old... I'm torn. Thoughts?

Oops. I can see the question has been answered. My mobile device wasn't displaying the threads correctly.

Thank you both! I am finding mental health challenging in terms of the thought process.

We are assigned a scenario in mental health for which we need to create a care plan. Mine is a young woman living in a group home who won't contract for safety and has a history of self-injurious behavior. She promises that if she is returned to the group home she will cut herself. We are to establish ONE primary nursing diagnosis, one outcome, two interventions. This is what I came up with. Thoughts? I had a difficult time deciding on an appropriate timeframe. We cannot use "Ineffective Coping", by the way. Self-Injury Care Plan Scenario Jillian is a 25 year old mentally disabled woman who lives in a group home with supervision 24 hours each day. In spite of this she manages to find ways to harm herself. Last night she removed the light bulb from a table lamp, broke it and used the broken glass to cut her wrist. She has cut herself for many years, stating that it helps her to feel better. The staff from the group home bring her to the Emergency department for admission to the hospital as she refuses to contract for safety. Multiple strategies for keeping her safe are discussed but she stands firm that she will find a way to hurt herself if she returns to the group home. She is admitted to inpatient. Nursing Diagnosis Risk for Self-Mutilation related to history of self-injurious behavior and living in a nontraditional setting (group home) as manifested by patient states she will find a way to hurt herself if she returns to the group home. Outcome Patient will refrain from self-injury as evidenced by no attempted or successful episodes of harming herself by end of shift. Interventions Intervention #1: Nurse will remove all breakable, sharp, flammable, and pointed objects from the patient's environment. Rationale: This patient is in crisis and, since she will not at this time contract for safety, is at high risk for imminent self-injurious behavior. Removing the objects typically associated with 'cutting' behavior from the patient's environment will help mitigate the risk she will attempt or succeed in injuring herself. Intervention #2: Nurse will monitor patient at frequent but irregular intervals to help ensure ongoing patient safety. Rationale: Ultimately the nurse will need to help the patient identify triggers to self-mutilation and maintain self-control without supervision. In this crisis period, however, the patient will require frequent monitoring as patient safety is priority in Maslow's hierarchy of needs. (Townsend, 2012) In addition, monitoring should be done at irregular intervals to prevent the patient from noticing a pattern and plan for self-injurious behavior when she expects the nurse will not be there to interfere. (Ackley & Ladwig, 2011)

CNA is a prerequisite for the program I am entering. I am surprised that spending two years in clinicals doesn't give one a better idea of what really working may be like, just from watching and talking to the experienced RN's?