Just a Dose

NRP for sure. If you can't get into NICU, try New Born nursery. Or other women services. L&D you see the baby coming and will see resuscitation. PALS certification for PICU, which has a lot of the babies that need surgical interventions done in phases. In one way, it's good to stick with only one, so they know that's your dream. But we all know how keeping your options open helps. I was in the Adult ICU and I know how much applicable knowledge I bring to the table, but HR and Pedi Units dont usually see it that way - they think Neonatal, Pedi, Women services or nothing. My NICU has hired a lot of ICU nurses and found them really easy to train, so they tap into that resource of nurses, where as new grads often got transferred to the Nursery, or did orientation in phases.

I had the same trouble going from ICU to NICU... especially when trying to transfer internally. So I had to check all job posting for experience required, some will say clinical or RN experience required, rather than ICU experience specifically. I bought the book to get certified as a CCRN, for NICU specifically- and read the whole thing. It helped me realize how much I already knew, even though in changing disciplines there is a different focus. Its helped me so much while being trained too. I would strongly advice buying that book, reading it, mentioning it in your interview with HR, and bring it to your interview. Get a highlighter - form page 1, and highlight the obscure things you don't know already. It will help later if you ever want to skim through it to find all that stuff again, and it is proof that you have read it. Parkland's Residency in Dallas was mentioned... that is a great program. I know JPS in Fort Worth hires RNs in the ICU, but you better be ready for really sick patients in ICU... I've really enjoyed working here (in the NICU). They are both Trauma 1 Hospitals. However, if you don't hear back from them - they might be looking at your address, and that relocating might be filtering you out. Over the year,s you've still learned a lot of things about Critical thinking, while doing your assessments you look at vitals and symptoms to determine where the patients condition and where he is heading, you look for clues in history, ecg, meds they take, their baseline vs current labs and diagnostics. Being in teli you may have used cardiac drugs. So many things are the same, especially the 90% nursing aspect. Just say it's your dream job - and don't put down your current experience.

You are missing a lot if you don't get to experience critical care, trauma, cv, neuro, general icu stuff, ER. Critical care is all about assessment and thinking. You also should see peds, labor and delivery, post postpartum, nursery, cath lab, surgeries, mental heath... It's important to see which kind of nursing your interested in, not to mention just sheer exposure, even if the stuff your doing wouldnt take a RN license to do. I was in Houston area, so maybe I was just lucky.

I took the HESI lots. There was a VERY long entrance exam hesi which tested the usual basics like Math, English, grammer and comprehesion, and then lots of Science. A&P, Micro, Biology and Chemistry. Then our school had a HESI for each clinical class and an exit exam HESI.

Hmmm, nursing actually affords you a lot of opportunities. You may have to go back for your bachelors, or do extra work like managing projects, or going into management ect like nicuguy said. But anyone who wants to advance or change must seek these opportunities and put in MORE work to get there. Like, computers for example, if you become a super user, then you meet the people that are involved in IT, run the committee, become the liaison for functional requirements. Then get a job that will certify you in that software - and now your getting closer to where you want to be. But then you mentioned pay. It is true that nursing pays close or a smidgen better than many jobs out there... but the stress, back breaking labor that leads to chronic pain, the schedule and liability are also what you get for being a nurse. Of course there are good things too, but this does not justify the pay of nurses. So, if you want to be paid more, than an additional - higher level skill is needed. (nursing is a high level set of knowledge)

There was this patient from PCU transferring to CV ICU. The patient's LOC had changed and there was an order to transfer and to get the lady BIPAP. The patient came to the ICU with a NC and the women skin was turning kinda mottled/greenish purple. The response from the PCU nurse was that the order was to TRANSFER first, then (apparently someone else) get BIPAP. They hadn't even called respiratory. Really? She can't at least prioritize orders?

Short explanation of patient diagnosis and treatment. Patients History and then Simple Assessment in my ICU is like: N: A&0 X3, Follows Commands, Moves All Extremities... or if they are sedated, what the settings on the drip are, and restraints, response after sedation holiday R: Vent Settings, ET Tube size and 23 at the lip Stats at 98% weaning, with orders to extubate in AM. Amount of sputum with suction C: Rhythm, SBP range, HR range, orders to titrating drips and the rate for blood pressure, HR whatever. GI: Diet, NGT to suction, Drains, Distention, abnormals - really. And if they had a BM GU: Foley or Voids, Urinal, output and anything abnormal, dialysis SKIN: Wounds Dressing, and orders for change with ointments IV: where the central line or peripherals are.. whats running, inflitration Abnormal LABS where appropriate, or diagnositic, findings, and interventions under the correct system. I haven't slept yet after work last night, but your thread has been what I've had so many issues with. That, and day nurses not understanding how MDs treat night nurses on the phone is 'different' than the 'great relationship' they have because they are so 'trusted' : are my two beefs right now. Funny cuz the MDs are really great when I interact with them in person too.

I've been nursing for less than a year now... I went straight to the ICU in an internship position. The statement nurses eat their young comes directly from this behavior. You've worked all shift and then the next nurse, treats you horribly, so you get to go home worried or upset. It's not you. You're probably doing just fine, she's trying to show her superiority. Although sometimes it is frustrating when report takes too long, but when they behave that way it takes even longer cuz your upset. Now that I'm learning NOT to trust what other nurses tell me so much, and to just read/interpret orders exactly as they are written/ protocol... Among other things, I've gotten much better and more confident. Even with that said, they should never treat you that way, its inappropriate. Now if they are rude to me, I will confront them, saying I don't appreciate the way they are talking to me, or whatever is suits the situation. I love the STARE you gave that woman. They generally stop, after their quick rebuke, or just give you the cold shoulder. Being new and not knowing every single medical word doesnt make your wrong. However keeping patient assessment simple is a must, only going into detail if their status declined, prognosis or medical treatment... especially whats required for their shift... new orders Like

So I'm glad your so excited about your new career. It seems like you are in a huge hurry to get work experience, but your direction seems a little unclear. There are so many facets of nursing, do you know what you really want to do? Figure out your motivation in getting so much experience right away other than single lifestyle. People usually try to get education behind them because it's consumes your time and you dont get paid, but it does increase your earning power. Is it a personal goal so you can feel more comfortable in any situation? Or is it to just be hired at the next place? Remember you got these two jobs with no LVN experience. If its really for bragging rights, then remember people care a lot less about what you know than how much you care about them. They care about how you treat them, what you do for them, and conversation can be dull if all you talk about its work. its hard to treat people that are important to you nicely when you work so much. More money in the long run? More responsibility? If these are you goals then maybe you could consider going back for your RN or BSN. Although I know it's hard to dive back into school right away, but there are prerequisite you could do one at a time. What are your long term goals, and is working 108 hrs a week the best way to achieve this? Balance in life is important... you work to live, not live to work. I've noticed that enjoying the journey along the path to your goal will make your life more full filling. Because the feelings after your achievement are not always as momentous as we thought - so we strive full force ahead for the next goal to get what we were looking for. I know that all sounds so cliche, but you can find some wisdom in .. Try listing your values in order of importance to you: Family, Love, Friendship, Work Experience or Career ladder, Money, Spirituality, Fitness, Nutrition, Traveling, Holidays, Education. Then list what you are doing to foster each one, you cant expect them to be there if you don't spend time on it. Do you have other interest like dancing, going out with friends, book clubs, being involved in committees, gorme cooking, decorating your house, reading, watching sports? Developing a core since of who you are is almost as important as experience. You're getting plenty experience with the first job you have, there are probably plenty of people with psych issues at your skilled facility. Are there psychologist that treat people there? Maybe you could try working closer with them. You don't really need the second job unless you need money. Remember YOU are of value, not just your experience.

I'm in Houston and I do know of several people that haven't found Nursing jobs... graduating in Dec 09, May 09 and Dec 10. But, nursing is still a much stronger field than others as far as find jobs is concerned. There are a lot of places in Texas that are in the boonies and apparently are really desperate... It is a lot easier for a college who graduates 15 students to say they all have jobs. I don't even know everyone in my graduating class. Honestly I dont think I could live in such a small town with nothing withing a hundred or so miles.

Oh, I didnt know you ment the NP program. This is con-traversal.... and I'm jealous. But go for it!

Hmmm, I kinda did what you did, but I used to make software for +5 years and made quite a bit of money. But, IT has a little more instability than your current job. I was recently blessed with an internship in the ICU. All of the New Grads who got this job had prior Bachelors/Professional Careers, besides the valedictorian at my school - but this was also a second career for her. Although we all received our ADNs. I would say to get you BSN at least, because its far more school to get your ADN tand RN to BSN than just your BSN. If you ever want to live/practice in another country I would carefully consider going straight for the Master RN program cuz some countries dont recognize it, even if you have an RN. Dunno why. Also, of course it's most likely way more expensive? Since you seem to be not so sure, there are part-time programs out there that take 3 years for the BSN. (UTMD in Galveston Tx used to have one) . So you can possibly continue your job AND go to school. Or of course there is 1 year accelerated BSN program, the idea of that scares me, because its just soooo much work. But if you can hack it, kudos. So if you decide this isn't what you had in mind, then one year isn't that long to be out of the environmental field - especially with 5 years of experience. If you think nursing would enhance your life and feel like you might really like it then your possibly right, and you never know til you give it a shot. Having RN behind your name is ipriceless, you don't even have to be a floor nurse. I'm sure you could integrate your current career with Nursing. Its good to do some research, and illicit opinions, but in the end, you know what you really want. Don't miss the opportunity, do what inspires you! In the end I decided to switch because I wasn't satisfied, didn't feel appreciated. I wanted to help people in a more personal way. And something I really LOVE is learning about health, diseases, treatment, ect - it is sooo much more interesting than trying to keep up and be well verse in software, networking, graphics, databases, security, operating systems, hardware, ect - in technology.

Yeah, it's too bad they don't protect the patients from hospital administration.

Most definately. In orientation today, we were told by a nurse educator that we were still held responsible even if we invoked safe harbour. This is true, we must be held responsible... but if the problem is found to be systemic or out of our control, then the blame will not be put on us. It seems that if you DONT invoke safe harbour - then technically, you can't really state later that you felt your assignment was unsafe. Then the educator went on to say that it was MOUNDS of paper work. (at the end of the shift). 14 pages isn't even as long as 1 care plan I had to do in school! So, she then repeated the point that they definitely want us to go through the channels, like the Charge Nurse, Unit Manager, Director, OA -before we have try to invoke safe harbour. How exactly are you supposed to do that when your super busy? Dunno. But hopefully you'd only have to speak to 1 or two people to get changes IMMEDIATELY, and protect our patients!

The OP seems to be looking for more valid uses of a RRT. Using the term 'based' as working exclusively in ICU, not no knowledge base of critical care. The code blue teams/rrts do seem to function on all of the units that I've seen (but I thought they were all MDs). I believe if a nurse or family questions treatment or opinions about change in status - that the team gives consults too.

I'm not sure exactly... mostly, it's what's natural argument. Next is probably traditional roles, and how he sees me as his wife (yet he wants me to have an income). I'm sure its for the benefits of breast feeding as well. I asked him about it after posting on this threat and now he's not so adamant, but wouldn't really talk about it. I've watched my sister do this with her two kids, being pregnant or breast feeding for the last 4 years. I'm sure she loves it, but she's had difficulty working full time and pumping in the restrooms. She tries to continue working while pumping by bringing her lap top with her. However, being somewhat of a feminist (more for equality, rather than die hard), she has a hard time with the work distribution with her husband. I'm not sure what I'll do if I ever have another baby, but I don't like being told what to do. It really depends if it is feasible to pump while working in nursing... however, we can hardly take lunch, so I can't imagine this. I don't think I could quit working again either, I'm not built to be a stay at home mom.

This is really interesting and very relevant. Thanks for sharing Canoehead!

My second Med/Surg was great. The hospital was small so they couldn't put all of us on the Med/Surg units. So we rotated around to see Cardiac Cath, PACU, Endo, Peri Operative... cant remember what else. Med/Surg is so broad spectrum, you should be able to find a patient with a disease process your interested in... Then follow that patients treatment, for example: if the have a heart block and need pacemaker - you get to see that. You do most definitely have to advocate for yourself tho, otherwise you'll passively sit on the floor. ICU experience is a must! I can't believe you don't have that. We were supposed to see the ER in my ICU rotation, and I was really disappointed that the hospital wouldn't permit us to go down there. One of my class mates passed out during clinical, so I did end up in the ER for a little while, but not the way I wanted to be. I missed out on alot of IV starting in the ER. You know, you can volunteer in the hospital, possilby answering phones on a unit your are interested in - not sure if that counts towards 'community' hours. My instructor, in Houston, suggested that we help these programs that send medical supplies to other nations. That was quite interesting. Other suggestion were to do emergency runs with the fire department. There must be some cool things you can do. 4 care plans a week, going to the hospital on the other side of town 4 times a week, paying $12 for parking everyday and having to cover more babysitters was absolutely exhausting. However, it is so much better to do some research and find someone your interested in for your clinical the next day, and even better to be prepared to take care of them! My biggest complaint was that no matter how involved I tried to be in NURSING, the things that require a license, and coordinating care, all the documentation... is that the nurse would be doing these things without you, while you bath and hand feed the patient. It wasn't till my management class that I had to care for 4 patients (basically by myself) and was able to say that "I can't do that right now, could you help me?" - to the CNA who was assigned to that patient. That was an interesting time. The CNAs were literally tattling on us to the nurses assigned to those patients. We picked one nurse 'preceptor' for the whole clinical. My preceptor was the nurse manager. She asked me - "Don't you HAVE to do these things?". I had to say, "No, this class (Management) is about proper delegation and learning to manage my time so I can get a handle ALL of the nursing responsibilities." Calling pharmacy about questionable dosages/ medications, calling MDs, rescheduling appointments, researching Meds, teaching, documentation. I think Management was the best class for clinicals because the nurses trusted us more... we were ready to take the NCLEX, as far as competencies were concerned. So in this clinical we were NOT to do patient care plans the night before, (we did have loads of other assignments to turn in each time tho). So during the shift we had to get patients medical diagnosis, allergies & history, current treatment, assessments, look up meds, do nursing diagnosis, interventions and goals, learn about treatment and patho (if you couldnt remember every detail), during the shift....." not to mention giving the meds and doing patient care, documentation, teaching, discharge papers, ect. Its not surprising we didn't have time to do ALL of the ADLs... They did this to simulate what it was really like to be given patients cold turkey. It made me feel more confident that I was ready (or not) to be a full blown nurse. Now, I really feel like many teaching hospitals understaff the CNAs because they expected nursing students to do it all. I understand that we have to learn this too, it is part of the scope of nursing - but when do you learn coordination and the stuff that requires a LICENSE when your so busy taking everyone vitals, doing blood glucose checks, changing bed sheets, and passing out trays, ect, ect?

My friend only complained about the titer because getting lab work done is so EXPENSIVE and many nursing students are on a fixed income. She, and many of us had Varciella when we were children and its frustrating to have to pay big bucks to prove we are immune... the younger generation had vaccines which do wear off, or never protected you in the first place, so it makes since. But its still really expensive, when they tell you last minute they put you in a precarious situation because you don't have time to scrounge up the $$. You can't just say they are complaining, it really is a problem. You can't tell me the nursing school didn't know this ahead of time.

I'm sorry this is all directed at you BabyCatchr... but we need to remember that there are many important things - like providing accurate info on how to use a car seat. Call me young, dumb and uninformed way back then - but when I left the hospital and the discharge nurse didn't have time to answer how tight the car seat restraints should be on my newborns chest... that ten minute ride could have killed him.

Everything that we do or say affects a life other than our own. Some of you ladies are really raising my blood pressure. If I had pree clampsia this would have far worse effects on my baby. BTW, I did have pre eclampsia... just as well I didn't have time to stress over breast feeding or not. I must say breastfeeding my baby through out the night and during the day was far easier than mixing and cleaning bottles. It was an endearing experience. As long as I eat healthy, didn't drink, smoke, take antibioltics, roll over on my baby, or anything else that would negatively impact him - it may in fact be better than bottle feeding and Gods/Natures gift.

Are you saying this to me? I am an RN, I just hadn't updated my info in many years. I didn't say I was non medical - I said they were the underdog. So anyway, I love this thread. I think it's more than stupid when people act like they know a lot about something when they clearly have no clue. This comment was about the topic - not anyones reply to me.

Canoehead, I love analogies - and I think this is one is great. You mention bragging rights... maybe this is where it all starts. Women who continue their careers also have bragging rights, and I'm sure SAHMs feel looked down upon. I most definitely agree that neither makes you superior. Stay at home Moms and breast feeders do deserve more credit. It's a great accomplishment, it's wonderful for the baby, and it's not easy. I do applaud SAHM and those that work and pump. Not that you need to hear it from me. I would much rather have friends, love and laugh - than compare, judge, put people down, and feel superior to others. I hope I haven't made anyone feel like their decisions or life aren't good enough.

Gosh, I musta made it sound like they are down to my elbows. Lol. I could still pass the pencil test too... but they did get smaller than they had been, and I wasn't exactly blessed. That's what really bothered me. Thanks for the articles, I was totally joking about the A&P. And I'm glad you came along to set it straight. [quote=nursel56; Just a Dose- you are absolutely right!! Everyone is different! People that downplay the importance of cosmetics, body image and self-esteem just don't know what they are talking about. Now that I have some 20-20 hindsight- the "mommy wars" that were so viciously waged mostly pale in importance after 15yrs or so. I used to lead new mom-baby groups (left nursing to be a SAHM) it shocks me now how judgemental other women are towards each other!! By all means, do what you feel is best for your baby, but please put away the bludgeon when other loving, conscientious mothers choose a different path!! Thank you for the support. My son is almost 10 now, and I've dealing with the family court system iconic phrase "the best interest of the child" for 11 years. (Adoption and the control begins before a baby is born). My values have been exploited, and I've been manipulated and controlled enough. I know parents (me) are important too, and we must stick up for ourselves too. I've realized that what's best for the core family is whats best for the baby... It's so easy to point fingers and say you can do MORE for a child, even when responsibility is supposed to be shared. So if the plane is coming down and the oxygen mask drop - put the oxygen on yourself first. Otherwise you'll both die. But don't forget that you are always worthy of consideration.

Thats a good point Roxy - the way nature intended is that women have to be with their infants every two hours to feed. Do you think that is possible for everyone these days? Why is it odd that people may resent being looked down upon and having to defend themselves. I don't think the author has any problem. She makes interesting observations about how she is treated, marketing, and science based evidence. I don't see where she condoned breast feeders. But it seems that you are judging bottle feeders by implying they are 'against nature' and 'odd'. The point is... that you need to FEED your baby they way that is best for your family.