dandk1997RN

I just wanted to clarify, for future readers, that the program at Samford is an FNP DNP program.

Sent you a private message, FL-FNP.

FL-FNP- I'm trying to gather a few of us together that will be starting the DNP-FNP program in January. I'm going to send you a message.

I don't know about the asking a doc thing as I didn't have to do that, but I sent email thank yous to all three people who wrote my recommendations. One had a particularly difficult time because the computers at my hospital don't have upgraded software and she had to try for days and finally did it from home. This happened while I was on vacation and it was under a tight deadline, so I got her a little pouch with a couple nice hand soaps- just a small gift for her tenacity. Finally, when I found out I got in (yesterday) I sent them all another email thanking them for the role they played in helping me get accepted.

To answer my own question...finished up my MSN-Ed at WGU earlier this year and just found out I was accepted into the Samford University DNP program. So it does really happen.

Just verifying that indeed, the assessment is no longer required of licensed RNs. I got an email saying I needed to do it, but having seen this thread, questioned my enrollment counselor about it. He said they are in the process of changing the verbiage on the website and automated emails. So thanks to the poster who save me a couple hours. :)

Disappointed to see nobody has any thoughts on this. Guess it will remain a mystery to me.

So I'm going out on a limb here since I think this is maybe an oddity, but I'm curious if any of you psych nurses have any input on a situation I encountered last night. I'm a cardiac nurse, so this isn't my forte- my only experience with panic attacks is my personal history of them. I had a patient last night who was admitted to the hospital last week with SOB, diagnosed with CHF/pulmo HTN, possible SIADH...among other things. Pt has a psych history of SI with two attempts, depression, anxiety, and former sedative addiction, had been refusing psych consults. The pt was on several psych meds (for depression) prior to admission, which were all d/c'd within the last few days- I'm not really sure why. The only thing still ordered was PRN benzo for anxiety. The pt had two panic attacks during my shift. The pt was very anxious at baseline, has been since admission, and got the benzo after the first attack. The second was about 5 hours later, too soon for a second dose. Both times it occurred when the pt had just sat up from a lying position, and the pt stated to me that things were fine until the rapid position change. No history of vertigo, no dizziness/light-headedness, VS stable...and the patient says this happens every single day. I was able to calm the pt down by coaching through breathing exercises, and showing the pt how to use the button to raise the head of the bed to assist with slowing the pace of the position changes. Thankfully, the pt has agreed to a psychiatry consult. I won't be back till later this week, at which point the pt will unlikely be on my cardiac unit. Has anybody ever heard of this? It seems bizarre to me that panic attacks might be related to position changes, unless the pt has vertigo or maybe platypnea (or, I guess, orthopnea in cases other than this.) Any thoughts at all? I would love any and all input. The pt has a lot of strictly medical stuff going on...I'm just wondering if they might be causing this odd (to me, anyway) psych manifestation.

Thanks so much for your thoughtful reply. I think I will apply to both the other school and to Frontier's bridge program and see what happens. My gpa from this degree is pretty competitive, so there is chance I can get I to Frontier- might as well try and see what happens. :)

Please forgive typos- using my Kindle and still adjusting to it. I am so torn. I'm an older new(ish) ADN (AAS) RN - 39 & 2 years intermediate cardiac telemetry experience with prior healthcare supervisory experience, BLS, ACLS,and studying for my PCCN, but currently no other national certifications. I am still rebuilding my life after a natural disaster 3 years ago. I have a great deal of experience with online education, I do well with it, but I don't like having to rely on other students to get my work done. As in, when I was doing pre-reqs for my nursing program, it drove me nuts waiting for other students to finally post in the last 24 hours of a module to be able to post the required minimum responses to earn the highest grade for the class. For these reasons (money, time, limiting my frustration when feasible,) WGU seems like a good option for my BSN and possibly MSN (education, likely, since I don't like management based on prior personal experience. This will also give me a fallback option for when I get older. ) I know I will be limited by WGU's GPA policy, and the fact the I live in New York severely limits my schooling options. But I also know other people have gotten into Frontier with WGU degrees. I would be saving probably at least a year and $15-20k by doing WGU-BSN/MSN--->Frontier PMC (and possibly DNP AFTER either option.) Does anyone know how competitive Frontier's FNP programs are? Personal or anecdotal experience with these programs? How "good" is Frontier's program, in your opinion (not that I can afford to be that choosy.) I'm looking for any/all input- thanks!!!

I as army. General discharge because of an injury- I chose not to fight it because I was young and stupid. Nobody cares at all about my discharge. I have never had employment difficulties because of it. Best of luck to you.

Coming back a year later to say I am loving nights. There are certainly times when I am tired, but I was so miserable before I was always tired. I now often have 5 or 6 days off in a row. I easily transition back and forth between day shift no-work schedules and my night work schedule. Sometimes I do go too long without sleep to enjoy family affairs (dd's soccer tourney after a long work shift, for example,) but only when I have the night off. I am also enjoying the higher shift differential (which was almost removed due to reorganization, but which we were able to keep in the end) and not getting different patients every single day (since most nurses on my unit work twelves and I was going to work in the middle of a shift.). So...thanks again for the input!

I don't really understand this reply. I believe we are all trying to be constructive. Unfortunately, the truth of nursing school can crush the excitement of a goal and hopes. I remember the excitement I had when I decided on that second career path and ran with it. I don't think any of us means to destroy your ambitions, but I'm sure some of us wish we had gone in with our eyes wide open, which I why we offer up our insight to you. I've BTDT with people trying to educate me about a situation they had experience with and feeling frustrated by their responses. All I can say is sometimes they were right, sometimes not. Maybe we are all wrong here- go out there and show us we're all wrong about your situation and become the best NP, husband, and father you can be (no sarcasm there- get out there and prove us wrong then come back and gloat in 7 or 8 years.).

Sorry- I didn't mean why I want weights is not about education- I meant it is almost never about medication, as in dosages. That typo was too confusing not to be addressed. Good luck with your goals.

Please forgive typos- I'm on my phone right now. I want to preface this by saying I should probably just keep my opinions to myself, but I'm going to go against my better judgement and put this out there. You may have noticed most of us aren't addressing your actual question. I don't think anyone means to be discouraging, but I see several red flags in your posts that concern me. What follows is not meant to be cruel, so please don't take it as such. Nursing school- 2, 4, or 6 years- is almost definitely going to hinder a relationship long before it ever gets a chance to make it better, particularly one strained by demands of getting into school NOW and threats if divorce if this doesn't happen. I won't comment more on your relationship as it is not my business, but just know I have the most adoring, patient, and loving husband and child, and nursing school was definitely very hard on our relationship. We had almost 15 years of marriage and TEAMWORK to fall back on, though, which I why we did okay. The other thing I personally feel compelled to address is patient education. This is only for the nurse to do, as Esme said. Your answer about weights, for example, would definitely NOT be what I tell my CHF patients about weights. If you, as a CNA, told me the pt ha a question for me about daily weights, I would jump on the opportunity to teach them about fluid overload, cardiac output, diet, efficacy of treatment, and how they should be caring for themselves after discharge, among other things. Why I want a weight is almost never about education or food intake. I can't speak for where you live, but where I live, you are LEGALLY not allowed to do any patient education. I believe Esme pointed this out to help you protect yourself from future liability. That is certainly my endeavor. All this being said, I do wish you the very best and hope you are able to fulfill your dreams. Sorry- I have no answer for your original question.

Heard through the grapevine that this pt ended up getting that LVAD, which must mean the clinical picture improved- was still in the hospital last week when I was last there. :)

I work on an intermediate cardiac unit (similar to step-down or progressive care.). Our cardizem is pretty much always titrateable (5-15mg) to maintain a hr90. I don't really worry if they are a little above or below unless their MAP sustains below 60- then I start looking more closely at their urine output (not always easy, lately, as I seem to have lots of super-old incontinent women on cardizem drips and strict i&o is no longer a valid reason for a foley.). Generally when they are taching along at 150+, upping the cardizem will bring that hr down for me and bp up, thankfully.

...and in addition to everything above, it's likely that if you correct that rate, you will correct the BP.

Thanks for all the great input- it is all food for thought and one of the reasons I love this forum. I don't have a very clear picture of what has been going on with the patient since the transfer to the critical care unit, as I no longer have a need-to-know, so to speak. I have gotten some anecdotal info as this patient was a staff favorite and people have been visiting. I believe the patient is still intubated. The milrinone was restarted the night of the transfer. The docs say it was not a seizure, not a migraine (which I never even considered, which is odd since I suffer them myself and know about the nausea and severe pain they can bring) and not a hemorrhagic stroke. Neuro said for days it was not a stroke, but I believe they are now thinking it was a TIA or embolic stroke. They are explaining away the pupils by saying the pt has had a lot of eye surgery and has something that one of them referred to as "surgery eye" which is not something I've ever heard of before and not something I can find any info on. I think it is an odd coincidence indeed that the eye thing, which is supposedly unrelated to the neuro event that clearly happened, happened as the neuro event was unfolding. So, in the end, embolic stroke is their best guess. This always made the most sense considering the underlying AF and lab values (sub-therapeutic on heparin and coumadin both, we had recently titrated the heparin drip and were getting ready for new labs to be drawn.) But it still doesn't precisely fit the symptoms. In truth, I never saw the pupillary changes- another RN transported the pt to CT and it happened on the way. The pt never returned to my unit. I believe they continued the amio (yes, a drug with many unfortunate side effects and adverse reactions indeed. We are actually a nationally recognized cardiac excellence hospital, so we have a LOT of cardiac pt, multiple cardiac units, and we don't use it all that often. It is definitely a drug of last resort for us, with strict policies on switching IV sites very frequently.) They restarted the milrinone drip in the CCU. They most likely restarted the heparin drip, although I am uncertain. The LVAD is probably off the table, because the pt has to be able to participate in the care of the device and it is still questionable if the pt can do that. I'll let you all know if I hear anything more. The "answers" I have are not very satisfactory, I'm afraid. And Esme, yes, they did repeat the CT. Nothing has showed up on any of them. Working cardiovascular care, I've certainly had pt's with strokes that didn't show up the CT, so that's nothing new, but we were hoping we would see something just to know what was going on. They were thinking the first one was so soon it just didn't show anything, but as far as I know, none of them have shown anything. Still a bit of a mystery.

Awww...all the great minds here and nobody has any ideas? Guess I will have to wait till I go back to work in a couple days and see if the docs have gotten any closer to sorting this out.

I was taking care of a frequent flyer a few days ago. This pt is in chronic CHF, awaiting an LVAD, and was ready to go home on a milrinone drip. Long story short, the pt couldn't go home for case management reasons, so stayed with us another night. Before my shift, the pt had a long run of VT that was paced out- the AICD never fired. The doc d/c'd the milrinone and ordered an amio gtt with bolus, which I started. The pt was also receiving heparin gtt, and was subtherapeutic with both that and coumadin (for underlying AF.) Pt starts acting a little weird, unable to sit still. Lungs are dim in the bases but no crackles, no edema anywhere. O2 sat is 92 RA, 100% 2LNC. All vitals stable, BP a little soft from the amio but MAP above 60. Pt then complains of mild nausea and headache. I try to treat the nausea first before giving Tylenol. While waiting for the Zofran to take effect (which it never did) the pt says the headache is now unbearable. I call the doc to the floor STAT. Pt is neurologically intact, chatting with the doc, and walks to the stretcher. We take the pt for a head CT. On the way, the pt blows a pupil- the other suddenly pinpoint and fixed. The pt was transferred directly to the CCU. Nothing has shown up on any head CT since the initial one. Cards swears it was a CVA. Neuro says no way. The pt became confused and minimally responsive in the CCU. I'm not back to work for a few days. I am really perplexed as to what this could be. Our first thought was hemorrhagic stroke, despite being subtherapeutic on ACs. I want to know what this was in case I see it again, but even the docs don't seem to know. Anyone willing to toss some ideas out there? It was such a strange situation I'd like to be better prepared the next time whatever this was happens again. To be clear, I'm not looking for any advice here, just wondering if anyone has had experience with something like this and what it turned out to be, because I'm stumped.

We put our used cables and boxes in a basket near the monitor station. Much more sanitary way to let someone know they need to be cleaned...

And if you don't mind small town, Corning is cute. My husband grew up near there and his mother still teaches at the college there. It is close enough to the Finger Lakes to afford some nice summer weekends.

I'm not sure why everyone thinks Albany is so unsafe- you're the second person on this forum to mention it recently. Maybe you don't want to be a lone lady walking down the street at night in the city (or ever in places like Arbor Hill or downtown if you aren't from there,) but most of the surrounding neighborhoods and towns are pretty darn safe. I'm a small-town girl who grew up on the NY/PA border and have lived outside Albany for the last 16 years. I have lived in Schenectady/Schoharie/Saratoga counties. We are hiring new grads in the area, and as long as you choose your neighborhood wisely, it's a pretty decent place to live- way safer than many areas of Florida. Slingerlands and Delmar are decent areas right near St. Peter's Hospital and Albany Med. Loudonville is nice and near Albany Memorial and Albany Med. Averill Park and East Greenbush are nice and near St. Mary's and Samaritan in Troy. Any town in Saratoga county is pretty decent and near Saratoga Hospital. Duanesburg and Princetown are fine and near the Ellis Hospital system. Are these places walking distance to these hospitals? No, but if you have a car, the commutes are pretty much Let me know if you have any specific questions I can answer for you about this area. I was scared as all get out when I moved here because I was only 22 and moved right into the city of Schenectady (which I would NOT do now.) But I generally feel safe here, and it is a pretty okay place to live. My commute is a little longer (by choice) and I have a nice home with a big yard but am only a 20-25 minute drive to Albany and close enough to NYC and Boston to visit them with a short drive.

Yeah, that. Can you show us your math so we can help you figure out where you're going wrong?