Ashrn1

Hey everyone, Could someone help me understand this better? I recently had a patient admitted with constant epigastric pain. Md wanted to do an EGD but the patient's INR was 4.3 on admission. She had been taking coumadin for history of recent mitral valve replacement with mechanical valve. Obviously, the md wanted the INR to be much lower so the EGD could be performed safely. They were trying to wait it it out and just let the inr decrease to less than 2.0 but it was taking longer than expected. That's when the md said the plan would be to start the patient on a heparin drip to. Make the inr lower and then once it was low enough, they would stop the heparin 6 hours before and go ahead and do the egd. I wondered first of all how this would be safe for the patient-considering the increased risk of bleeding during the egd after having the patient on a heparin drip. Also, why would they want to put her on heparin anyway if the goal was to decrease the inr? Wouldn't heparin prolong the PTT and increase the inr? Please help! I'm confused. Thanks!

I moved to Chicago from Chattanooga 9 months ago, but I have lived in Chattanooga and surrounding areas all my life and know the area very well. I did my clinicals at Erlanger hospital and worked at Memorial. I can tell you that, at least last year, both Erlanger and Memorial were starting new RNs out at about $18.05/hr. However, several of the hospitals in Georgia were able to pay better-like $22/hr. I think it was Hamilton Medical near Dalton, GA that paid well. However, one of my friends who went to work there said that the nurse to patient ratios were also higher there. It just depends on what you're looking for,what's close to you, etc...Depending on what type of nursing you're wanting to do, you're probably going to get the same type of experiences as a new RN whetever you go..might as well do it where they pay the most. Erlanger is better if you're wanting to get involved in trauma or with babies/NICU, etc. Also Erlanger is a teaching hospital. Memorial is the center for cardiac and oncology excellence. I don't know anything else really about the ones in Marietta.

I just moved to the same area in the west suburbs in IL a couple of months ago and was hired as a NCII at a hospital here. They started me at $27.50/hr plus $3.00 shift diff and $2.00 weekend diff. Hope this helps!