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Explaining circumcision to mom....
I have a lot of strongly held ideas and beliefs that are very controversial, but at work I stick to the scientific facts and would never offer my own opinion.
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ADIOS ANESTHESIA
Maybe you should be a preacher.
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MUSC Trauma Unit
MUSC is hiring new grads. Jobs maybe a little tighter now (but I'm not sure) and the new grads who worked as techs while in school are probably getting the jobs because they are more experienced, already in the system and the managers already know their work ethic. There are at least two new grads in the unit I work in and its only 7 beds. As for STICU, I was hired there as a new grad back in 07. I've travelled since and am on my 4th ICU, still by far my favorite pts.
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Just accepted my first contract!
Congrats! I'm about half way through my first assignment in CO. Just like any other experience, it's what you make of it. I'm definitely glad I did this. It's such a great social experiment to throw yourself in a completely new situation in a new place and sort things out. I don't know if you're traveling alone or not but I find I'm friends here with very similar people that I hung around in SC. Like you find people to fill the empty spots, if that makes since. As for the hospital. I came from a big teaching university to a smaller private hospital. That's been a big change. I think the hardest thing to do is to keep my mouth shut about trivial things. We all have our way of doing things and even if it's a little better and easier sometimes you just have to go with the flow. It's easier to just be as helpful and available as possible without stirring the pot. On the negative side, I don't really like not having ownership in the hospital or staff. I realize that's why most people travel, but you really see people's true colors. They don't have any reason to invest in you because you'll be gone in a few weeks, so you really see people's true colors. Just stay open minded about things that bother some, like getting floated a lot. You have to look at it as just another experience and take advantage of the opportunity to improve your skills. The learning curve was pretty steep at first but that's what makes it exciting. People are mostly the same, if you enjoyed your job back home you're likely to enjoy your job traveling, if you were miserable and complained all the time that's what you'll do here. Keep a positive attitude and speak up if you need help or don't understand something. I found my reception improved when the regular staff realized I was about doing a good job and helping everyone out, some people have a little animosity towards travelers because whether you are or not, they perceive that you are making boat loads more money than them. So just stay positive and take advantage of a great experience that most jobs and people don't get. Have Fun!!!! Brandon
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Is anyone having trouble finding a good assignment out west?
I was having the same problem, started looking c three smaller companies in nov. Wasn't having any luck so one of my recruiters reccomended another recruiter who was a friend of hers c a large company. Had a job within 24hrs of signing on and am on assignment in CO now. Try a few more companies, I think that, plus flexibility is what it takes in these tough times. My job now isn't ideally what I wanted but its a start. Goodluck.
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Job outlook for travel nursing in this economy?
Thanks for the advice, google maps says about 3 hours to keystone. I'll make a run and see how it works out. I have a friend in Denver I could stay with. Coming from the east coast I don't have any problem driving 3-4hours to snowboard for the day. I'll just have to check it out when I get there. I'll check into the other areas as well. Thanks Brandon
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Sepsis case
In most of the studies I've seen Norepinephrine is the first line however There are some new ones that suggest Vaso may work better. Like someone said it depends on which doc is on. I think the sepsis goal is a cvp of at least 8. I like looking at urine lytes in the face of low uop and rising creat. It usually comfirms pre renal and gives some ammo for fluid. Hope the pt is doing well.
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Job outlook for travel nursing in this economy?
I'll be in Pueblo from Dec - Mar. Thinking of getting a season lift ticket. I've been to Keystone before and loved it. They have a package deal for Keystone, Breck and one more for a pretty good deal. What do you think? Thanks Brandon
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Job outlook for travel nursing in this economy?
I just got a contract in CO. I was looking with 3 smaller companies for about 4 weeks with no luck. Two of the companies were working hard. In my perception there were a lot of jobs out there, however I don't have anything to compare it to as I'm a first time traveller. In my situation the problem was that I've only been a nurse for a year and a half and this was my first travel assignment. Most hospitals didn't want to take me. I signed up with a larger travel company because they get more exposure and had a job in less than 24hrs. I was real flexible on the details of my assignment and I was told by recruiters thats what it takes in this market, but most of the jobs I was submitted to were places I would have liked anyway. I to was a little nervous about leaving a secure job but so far I think it'll work out fine.
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Take provided or Find your own housing?
I'm looking at assignments and when getting the pay breakdown it seems that the companies are keeping anywhere from $2000 to $4,500 a month for providing my housing. I've been calling hostels, searching craigslist, and checking with exteneded stay hotels. I can always find places to stay, anywhere from rooms to rent to two bedroom condos with prices ranging from $350 to $1200 a month with the avererage being around $600. All these places are fully furnished with utilities included. At the very least I would be bringing home $3,000 per assignmment more than if I took their housing. How many of you go this route and find your own housing? Even if it means showing up a week earlier it would more than pay for itself. Any experiences would be appreciated. Thanks Brandon
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Another hurt back
Thanks lpn. I havn't ever been to a chriopractor but a friend reccomended a good one. She's had a very simlar issue also. I'll never turn a pt alone again. You never realize how important your back is until it's hurt. Take my advice and be extra careful. I always get asked to help, which I don't mind at all, just from now on I'll grab another person on the way. Just getting home and getting some ice on it has helped. A few days taking it easy and I think I'll be fine. Thnaks Brandon
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Another hurt back
I hurt my back last Sunday while turning a pt. I work Friday's and the weekend so I was off afterwards. It was getting better, so Wed I was messing around in the yard a little, nothing crazy just washing the leaves off my boat. When I was done I noticed it was hurting a little more. Played pool later that night and still noticed it had gotten a little worse. Well Thu about mid day it got real tight and I couldn't walk because of the pain. Never had any numbness or tingling. So I went to work and filled out a report and went to employee health and saw a FNP. She said it was classic lumbar region strain, gave me some meds and an ice pack. Sent me on my way and told me to go to work the next day on light duty. I couldn't work Fri, it was difficult to get off the couch so I stayed home. Well I went in today (Sat) and made it until noon, my pain was getting worse and I couldn't do any pt care. We had someone on call so they came in for me. I have a follow up apt with an MD Tue at employee health. I've never hurt my back like this before. I can't bend or turn, it hurts to get up and down. Has anyone had a strain like this? It seems to be just a little left of my spine. When it was at its worst it felt like a tight muscle. Should I request an x-ray? Just curious if anyone has had a similar injury. If so how long did it take to get better? Thanks Brandon
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Atropine
Yea some people just have really low resting heart rates. Lance armstrong is in the 30's I've heard
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Atropine
You are right Love, only give it if the pt is symptomatic. It can be a little nerve racking to have a hr around 30-40, but if the pt is compensating accordingly no need for meds. However treating the cause if in fact it was elevaed icp's may be an option. It sounds like he could have had increased icp's. Agitation and change in LOC are classic signs. If you have a pt in complete heart block you need a pacer. Antropine works on the SA node, and since there isn't any comunication between the atrium and ventrical you could cause more trouble. Another interesting note that I just learned is atropine isn't affective in heart transplant pt's because the conduction system isn't intact. :)
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"If you want to be a doctor, go to medical school"
Since the pt wears 3l at home, maybe the Dr realized the pt was anxious about being on 2l in the hospital and wanted to be bumped up. Nothing like a little placebo affect from that insignificant rise in fio2. Just another perspective.