UK2USA

We swab nasopharynx on admission and again every 30 days for every patient. In a previous hospital we swabbed nose, throat and collected a stool sample for every patient.

I have just bought the practice tests from this site - 2 sets of 5 tests at a total cost of $100. To be honest I found way too many questions that should not be included in the Peds CCRN: Medication dosing questions where peds dosing is not approved. Questions pertaining to Nurse Practictioner licensing and documentation. Medicaid reimbursement for PNP questions. A lot of adult questions (which I can justify with the idea that older teens can be treated under adult protocols), but of the 7 tests I have completed I have had at least 10 questions that relate directly to geriatrics. Numerous questions regarding conditions that I do not consider to be critical care... including warts, athletes foot, oral contraception. I have also found several errors with their answers, particularly where the answer they give may be 'b)', but they go on to explain why 'c)' is correct - this throws off your score if you answered 'c)' correctly, but get marked incorrect because 'b)' is the answer they have given that question. The first time I spotted this I contacted them and they apologized and corrected the question/answer - I have now spotted 6 of these and have stopped taking the tests as I doubt they are preparing me appropriately.

Very interesting - thanks for the article.

And now a true story. On our unit we were caring for a pt who was in heart failure. He was so skinny, but had this bloated belly. He was a DNR case and was fully aware that he was going to die. One evening he started to go downhill very fast and was very aware of what was happening and was very scared. He suddenly revoked the DNR order and asked that we resuscitate him. What happened next was bizarre - he arrested and we set about the resus, except the bed kept repositioning into a chair position. It must have been a short in the electrics or something. Anyway the resus was unsuccessful - coding a person in a seated position does not work well. A few months later I was looking after a patient who had a really rocky recovery post op. Her mother was terrified. When we were finally able to extubate her the mother started to update her on what had happened and how close to death she had been. The patient turned to her mother and told her not to worry.... the skinny man with the big belly had been with her and had told her she was going to be ok. She couldn't tell her the mans name - he had never told her.. but he had a bird on his shoulder. The patient that died had an eagle tattooed on the upper arm!

Not a ghost story (maybe an urban myth), but scary all the same: A group of 4 nursing students were on their last day of a clinical placement and were very happy to be finishing. They decided that they would go out after their shift had finished to celebrate. However, by the evening one of the four had had such a tough day that she decided to stay in the dormitory and get an early night. The other three head to the nearest bar, where one of them realizes that she left her cash back at the dormitory. "Thats ok" said the other two, "we are walking past the dormitory on our way to the next bar, we can pick up the cash then". They had a few drinks and when it came time to move on to the next bar one of them slipped into the dorm building. Seeing no light on when she opened the door to their room she decided to be kind and knowing that her cash was on her bedside cabinet she tiptoed in with the lights off, grabbed her cash and tiptoed out. Several hours later..... The girls arrive home in the small hours and as they are walking up the street they see a lot of police activity. As they reach the police cordon they are stopped and asked to move on. They explain that they live in the dorm building and are immediately taken to a senior officer who explains that there has been a terrible incident and that their friend has been killed. They are not allowed into the building because the forensic team is there. One of the girls needs to get her medication which is in the room, so the senior officer relents and escorts her into the building. When they enter the room it is full of forensic teams in white jump suits. The matress is covered in blood. When she goes into the bathroom to get her medication she sees a message written on the bathroom mirror in her own lipstick... "YOU WERE LUCKY THAT YOU NEVER TURNED ON THE LIGHTS!"

My fiancee had terrible trouble establishing some credit history in the USA.... she received knock back after knock back.... each time damaging her already shaky score. Then someone gave us a really great idea: Talk to your bank manager about a secured loan... something small like $500. As security you give the manager $500 which he puts in a savings account. Specify that you only want the loan to run over a short time.... say 2 months. Then you simply transfer $250 from the savings account to your loan account, plus a couple of dollars for interest. The bank HAS to report this as a completed loan.... it doesn't matter that it was for a small amount, or for a short period. It counts as a 'loan repaid in good time and without penalty' We did this and within 2 months my fiancees credit score had soared. I only wish we had heard of this 12 months before when we couldn't get on the credit history ladder.

I came from the UK to the USA about 3 years ago.... at that time there seemed to be little difference between any of the international agencies. Most seemed to be paying between $20 - $28 per hour for an 18 month contract depending on the geographical area. Most agencies will give you 1 week of paid leave per year. One word of caution.... if your unit has a low census and you are not required to work you will still owe your agency a shift - the same goes for sick leave. This may not seem like a big deal, but one of our nurses has been cancelled so regularly that it extended her contract from 18 months to 22 months. When you sign on in a staff position,, or if you sign on for a travel position within the US the salary increases dramatically.

No I think it is the one with the guy from the Office and what-his-name that used to be in Corrie.... you know the guy with the waterbed!!! Helpful aren't I? I really miss the soaps.... and like madwife I miss the news. I will be back in the uk next week for the first time in 3 years and I am going to overdose on corrie, eastenders and emmerdale!

I too have heard this for many years... except I was told that a LSDR (left sided death roll) is to do with pressure on a dying left ventricle. Supposedly this slight increase in the pressure of the systemic 'pump' can push the heart into final arrest.

Hi all, I am looking for some info regarding common practice with Peds PICC lines. We are in the process of writing a practice guideline for heplocking a PICC. Q1. Do you heplock a 1.9/ 3 Fr PICC in your hospital? Or do you maintain a KVO? Q2. If you KVO... do you use a heparinized solution? Thanks everybody.

You are absolutely right to have been concerned about starting this drip. I was trained in a unit where NO pressors are run through a peripheral line... and one look at a nasty infiltrate will explain why (see examples here). However since I moved to the USA I see it happening more and more.... it makes me very uncomfortable. IMO Q1 assessments of the site is the absolute minimum I would check. I usually check Q15 minutes for any pressors that run through a peripheral line (also potassium, vanco, gent or any other harsh meds).

Hi all, I am originally from the UK and moved to the USA 2 years ago... I am now helping to review all of our policies and procedures... it is fast becoming clear that a lot of the policies are outdated and established through tradition rather than research. I am looking for any help with central line protocols. I would love to get some different protocols to study before forming our own. If anybody can help it would be most appreciated. Please PM me if you can help and I will send you my email address. Thanks

Hi all, On my unit I am helping to review all of our policies and procedures... it is fast becoming clear that a lot of the policies are outdated and established through tradition rather than research. I am looking for any help with central line protocols. I would love to get some different protocols to study before forming our own. If anybody can help it would be most appreciated. Please PM me if you can help and I will send you my email address. Thanks

Hi all, On my unit I am helping to review all of our policies and procedures... it is fast becoming clear that a lot of the policies are outdated and established through tradition rather than research. I am looking for any help with central line protocols. I would love to get some different protocols to study before forming our own. If anybody can help it would be most appreciated. Please PM me if you can help and I will send you my email address. Thanks

Hi all, On my unit I am helping to review all of our policies and procedures... it is fast becoming clear that a lot of the policies are outdated and established through tradition rather than research. I am looking for any help with central line protocols. I would love to get some different protocols to study before forming our own. If anybody can help it would be most appreciated. Please PM me if you can help and I will send you my email address. Thanks

Dude, your situation says more about your supervisor than it does about you... If you have a desire, the strength and that certain "gift" to be able to work with kids then of course you can be a peds RN... OF COURSE, OF COURSE, OF COURSE. The reaction you had from that ignorant, narrow minded supervisor should be ignored... what is next? will she tell you that you cant work with women? perhaps you would take advantage of the mentally disturbed? C' mon ... (he says with sarcasm) everyone knows that us male nurses must be perverts!!!!! DON'T GET SUCKED INTO STEREOTYPES. DON'T, DON'T, DON'T LET THIS STUPID, STUPID PERSON DEVIATE YOU FROM A CAREER THAT YOU ARE GIFTED IN. THIS MAKES ME SO MAD...

This is a great idea for a sticky Kay.... When I came to the US from London 2 years ago and I was looking for car insurance I was bewildered. Luckily for us we had met a really nice guy (a car salesman would you believe?) who helped us out.... but it was still a shock, let me paint you a picture: In the UK I have driven for 15 years and my fully comp insurance is only 600 pounds a year. I have never had an accident and qualify for total no claims discount. When we got to the US we couldn't find car insurance at first because we hadn't been in the country for over a year. Our car salesman vouched for us and gave us a reference for the insurance company who accepted our application.... BUT, because we had only just qualified for our Arizona driving license we were told we would be treated as brand new drivers... in the end we paid $1800 for a 6 month coverage on a VW Beetle, that meant that our monthly bill was $300, after 6 months it came down by $50/month then by another $50/month. As if it wasn't bad enough that we had to pay so much, the insurance company needed to have 6 months up front as we had no credit history.... guess what, our US credit cards only had limits of $500 because we had no credit history with them either... which meant we had to use UK cards and send money back home to pay them off. For those coming over from the UK... speak to your insurance companies first, I have been told that some have arrangements with companies here (although I don't know which ones... I could never find out!)... this may help to reduce the cost a litlle. Good luck to all of you... keep a stiff upper lip, it is a jungle out here!!

I can see your point, but I think that leaving blanks in any form is a little dangerous. Let me explain: about 3 years ago I was working an agency shift at a hospital where a nurse had made an error (she left the allergy list blank and the patient was given penicillin - which she was allergic to). The nurse was really relieved that her admission paperwork had blank areas on it so that she could go back 2 days and complete them to avoid getting into trouble. She was caught, fired and went before the BON. The moral of the story is that if you can delete a category to avoid an empty space - do it. If you can chart n/a for not applicable areas - do it. But never, ever leave a chart blank. Think about how you would feel infront of a lawyer with a chart that you half completed - with the other half filled in incorrectly by someone else..... and your signature at the bottom. Hope this helps

OK, not a flight, but a peds critical care transport, travelling at speed in the back of an ambulance through London. Came through red lights with our 'blues and twos' (lights and sirens) running and got t-boned by a driver. Ambulance almost tipped onto its side. Dr and nurse thrown across the working area, suffering shoulder and back injuries - ended up being treated in the emergency dept. The intubated patient remained strapped to the stretcher, ett stayed in... managed to avoid being hit by any of the equipment (or staff) that became airborne!!!! Lesson learned: tie down all equipment and keep your seat belt on!!!!

Steve, most of the agencies will set what they consider to be a safe amount of experience, however the hospitals will employ based on the individual nurse. I know that in the UK we are very impressed by the level of training we see in Ozzie and Kiwi nurses. My advice... go to one of the ICUs you are interested in and speak to the manager. It will make a lot of difference if the Unit Boss calls your agency and asks for you by name.... watch the 1 year recommendation disappear!!!! Good luck

Kay, when looking for somewhere to rent be aware that some places in Phoenix are pretty expensive. Especially areas such as Scottsdale where you will pay prices similar to London. There are lots of new areas being developed which are reasonably priced. We liased with a real estate agent whilst in the UK. I will email you his name and number in the morning when I get home from work. He was exceptional, picked us up from our hotel and even took us around to show us the stores that we would find useful etc. When he showed us around he spent a couple of hours finding us a great home and then 6 hours showing us Phoenix!!!! I would avoid certain places such as areas around the airport - just because of the noise and trying to sleep during the day. Let me find his details and I will email you tomorrow. Regards, Alex

Well done Kay, I am really pleased for you. Don't forget that if there is any info I can help you with just give me the nod. You have the email address. Again, my congratulations..... see you in the desert!!!!! Alex

Tonight I phoned home to the UK and spoke to some colleagues and friends who were in the middle of the blast zones and found themselves recieving numerous traumas (despite being in a paediatric hospital). I was glad to hear that all of my friends were safe (my sincere sympathies and best wishes to those who were not so lucky). One thing that everyone has reported back is that the medical and nursing staff throughout London did a fantastic job, setting up field triage and treatment centres and dealing with 700+ casualties amid the fear and confusion that descended upon the city. I would like to voice the pride I feel in my colleagues, my thoughts are with all of London. I have never been more proud to be a British nurse.

Whilst researching for the move from the UK to the USA I contacted several hospitals Stateside to see what sponsorship was available... It certainly seemed that most hspitals were more approachable about sponsorship than taking on international travellers through agencies (although this was not always the case). My advice would be to decide where you wanted to work, then telephone the human resource dept for that hospital. All your q's will be answered.

I too gained a lot of weight whilst in Nurses School. I lived in the hospital I trained at... which meant no exercise getting to/ from work. Because of the shift times and the proximity of the hospital canteen usually headed straight for the fast food section. Don't worry too much about it... I learned that I needed to allot a portion of the day to work out. Really it comes down to a simple equation.... I eat less calories than I burn off during exercise... I don't starve myself, choose foods wisely - and stay away from the hospital canteen. Oh yeah... and I use the stairs rather than the elevators whenever possible. ... now if only I could get rid of the cigarettes...