Soonstudent

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.

Maybe you should be a preacher.

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.

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

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.

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

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.

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

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.

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

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

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

Yea some people just have really low resting heart rates. Lance armstrong is in the 30's I've heard

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. :)

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.

I havn't been a nurse that long. Actually barely had the required hours to take the test. Granted there are some difficult questions but I don't think it's as bad as it's made out to be. I took a two day review class that helped with questions that were a little different than current thinking, and reviewed the systems. Put in a little more time with lab values and the EKG/MI. It really depends on your study habits, let that guide you on how you prepare. Do what works for you. Good Luck. Oh yea I got a $1200 bonus for passing!

The first one looks like partially compensated metabolic alkolosis. Your PH is more on the basic side. Your elevated Bicard is causing this. The elevated CO2 is trying to correct this. Don't confuse this with resp failure because the CO2 is high, it's a compesatory mechanism. The PO2 isn't the greatest, but I don't know how much O2 the Pt is on. On the second one the pt is vented. You've taken out the pt's compesation, causing their PH to rise. Still metabolic alkolosis, thats's the problem. pO2 still not the greatest. what's their FIO2?

So true!

I think it is. I think it is a challenging profession when compared to others, but I think it all comes back to your perspective. Sure there are easier things to get through than nursing school, but it's just because we arn't used to being in the situations nursing school puts us in. You have to be able to adapt and embrace change. Take it one step at at time. The payoff is great when you're done with school. I love my job, I'm making the most money I ever have, and I only work three days a week. Remember, it's all about perspective. Try looking at your situation from someone elses point of view that may be in a worst situation.

Gunsmith, Soldier, Heavy Equipment Operator, Pharmaceutical Manufacturer, Golf Caddie, Deckhand on a Tallship.

I'll second that!

I'll second that!

You are exactly right on the access issue, there is always some danger, I didn't mean to imply that there was none. The pt is probably a hard stick, or has a chronic condition that warrants a picc. I don't know, however in this situation the pt was not harmed and everything turned out ok. If the picc was pulled back 4 inches that would put it in the subclavian vein, still patent for emergencies. The intent of this is for the new nurse not to beat herself up about this. It happened, everyone is still alive, and I'm sure she learned a lesson.

I just graduated last May and started in one of the icu's at musc. It's a great place to work. With the teaching hospital I think you have a lot of autonomy and great opportunities to learn. It's one of the only level one trauma centers in the area. If you have any questions let me know. I can point you to some of the better areas to live also. I had 16 weeks orientation. In my experience I felt well recieved as a new grad, but I had worked for three years in my area as a tech. I think the specialty areas prefer experience as a tech or nurse extern, but I have heard of them hiring new grads without this experience.

I think you summed it up pretty well Tweety. After being a nurse for 6 months now and a couple years after the start of this thread, I can say I absolutely love my job. It's been great, I had 16 weeks orientation and have been on my own for about two months now. The more I learn the more I enjoy my job. I have been over my head once or twice but there is always someone close by to ask questions. Nursing has definetly changed my life for the better, and hopefully this time next year I can update you guys snowboarding from CO or living on my sailboat in St. Thomas. :) Brandon