CNL2B

If OP is planning on starting a program now, it is likely that she will have to be admitted to a doctoral level program. That is the point. Just because there are Master's Degreed PTs still out there doesn't mean that that is the level that most schools are training at now.

Don't think this is true. There are still Master's Degreed PTs out there, as there are RPh's, etc. It looks to me like most accredited programs are now DPT programs. The accrediting body that I linked wants all PTs to be DPTs by 2020 and it looks to me like most the schools have gone that way. There are a handful of Master's programs left. I'm not going to count how many are DPT and how many are Master's, but it looks to me like the MPT is being phased out. This site only lists 1 bridge program and it is for PTAs, not RNs.

APTA | CAPTE Here is a list of accredited programs. All it takes is a simple internet search to find the info you are looking for. It is my understanding that all PTs are now doctorally prepared. I did not go through all these programs listed but the 4 that are available in my state are DPT level programs. They require a Bachelor's degree so as long as you have a BSN and meet the other admissions requirements I think you would be eligible to apply. There are PTA programs out there as well, which are Associate's Degree level programs to my understanding.

An older kid or adult? That seems excessive to me too, regardless.

I'm not a pedi nurse but I sat in on my son's circ (outpatient at 1 mo, in a clinic). He got a local (I think lidocaine). He cried more from being tied down to the board than the procedure itself, for which I was thankful. I would not have been happy with EMLA or hurricane spray as a parent. That stuff is topical -- doesn't go very deep at all. I doubt it would have been sufficient pain coverage for the procedure being done. It's also my understanding that you have to let EMLA sit there for 20-30 minutes for full effect. He also got some relief after he went home for a few hours with the local.

I can't tell you about meds you didn't ask about, but of the ones you did, this is how I do it (per facility guidelines): Mag - 1 gm over 15-20 minutes, 2 gm over 1/2 hour K - 20meq/hour MAX, must be on cardiac monitoring to run it that fast. The floors with no tele can run it at 10meq/hour only. Calcium gluconate/chloride - I dilute in 20-30cc and put it on a mini-infuser. Usually goes in over 20-30 minutes. I think this stuff is in most med books also (administration times.) That's where we get it from, mostly -- we've just memorized it over time.

I think you should go to management with the concerns you have with this intensivist. It is NEVER acceptable to hang up on another caregiver on the phone. It is NEVER acceptable to not listen to nursing concerns about patient that he is covering. This is an attitude that needs to be broken, and quickly. The issue with the respiratory order (CPAP/BiPAP?) - IMO, it is absolutely the RT's responsibility to be checking their orders and doing their own work independently. They have a license too. If you have an RT that covers your unit and isn't floated 15 other places, this should be an expectation. This is one of my pet peeves, actually -- I have worked places where RT is great and they do everything, and I have worked places where you have to call them for every little thing. (I'm also a little confused in that it was a new order but the patient was on it the night before -- what's up with that?) Is it your responsibility to notify RT for these kinds of orders? Is it something the clerk could have done, but missed? Did RT not see the patient for the entire shift anyway? Were they supposed to be following the patient? I would talk to management as well about the RT role and what the expectations are. Yeah, maybe you dropped the ball (maybe....not 100% sure on that, especially since the patient was fine) but RT should have picked it up and ran with it. Being overworked and exhausted does no one any good. Man, I feel for you. I have seen this kind of crap go on and on 100+ times at a number of facilities. I wouldn't pin this on you, actually -- your system is a crappy system -- obviously it failed here. I hate it that this kind of stuff gets pinned on nursing all the time -- and actually, you pinned it on yourself! Let me give you a piece of my very best advice. Ready? Here it is: DO NOT TAKE FULL RESPONSIBILITY FOR SYSTEM ERRORS. Learn to recognize yourself as simply being a piece of the problem, and don't personalize it. This was you in this instance, but it easily could have been one of your coworkers. This involved other departments and other caregivers. If you keep on pinning this all on yourself, you are opening yourself up for disciplinary action for issues that aren't entirely yours. Don't do that. Did you do an incident report on this? I feel that it warrants that, since an ordered treatment went 8-12 hours without getting implemented -- if we missed 8-12 hours of an antibiotic, we'd have to write it up. I see this as being a similar scenario. Hopefully you did, and somebody that can actually do something about it will examine the situation and try to fix how things operate around there (I wouldn't hold my breath, though, unless you have some managers that are really good at/like operations.) Anyway, that's my two cents.

Are you orienting this person? If you're not, I would stay out of it. She obviously doesn't want help -- at least, she doesn't want help from you. She has her own license. She has the right to figure it out on her own if she wants to. The only way I would get involved with what she is doing is if it was something that wasn't safe practice. Likely this person is hurting herself and her ability to get up to speed, especially if she doesn't have previous inpatient experience (sounds like she doesn't if she's only been in OR and management.) Let her do it. You can't fix her attitude. She will either pick it up on her own quickly or fumble around until she does. Either way, it's not really your deal.

These terms (BLS/CPR) are often used interchangeably. If you took a CPR for healthcare providers I think you are probably covered. I wouldn't go ahead and take different one unless I was specifically asked.

I'm not sure what hating your job has to do with having/not having a BSN. Care to rephrase? What "job" are you talking about specifically -- bedside nursing, or other areas? I'm not sure what you are asking. Seeing that I don't really know what you are asking, I'm going to answer any way I want -- no, I don't hate my job. Some days, I feel the burn (out.) Some days, it's all good. I love my coworkers. I work in a great, supportive environment. That has made the difference between me having a horrible day and going home in tears -- it's really, really important, and I am really lucky to work with the people that I do. Retention is a huge issue, especially considering the cost of training in a new nurse. People are hanging on to their jobs more than ever now, though, with the market. I'm wondering if having people quit is less of an issue than it was 5 years ago.

If what the above poster is true (with you giving 30 mEq of KCL PO = 1200mg), For a K+ of 2.6, getting 30 mEq PO + 40 mEq of IV KCL isn't all that much, especially with normal renal function. It's also not uncommon to administer by both routes at the same time. What I am not seeing is how fast you administered the 1L bag of fluids with the 40mEq KCL in it. Did you put it on a pump as IVF at a certain rate? That should have been fine. You didn't rapidly infuse a bag of IVF in with 40 mEq of KCL in it, did you? That is the only mistake I can come up with in this scenario.

Good short post, good info. This is what I was thinking all along. There can't be any way that pouring a diluted bleach solution on an open wound is going to help it heal.

OP, I see that you are 18. I am assuming you have had no nursing education at all at this point (didn't look at your whole profile, perhaps you are a CNA.) Does ANY entry level nursing program prepare you for the workforce? In one word, no. It prepares you not to kill somebody. I always like to say about my basic nursing education that I learned a little bit about a lot of things (all health related, of course.) I didn't learn anything to any degree to be any kind of an expert. Pretty much all I could say when I first got out of school is that I was ready to orient to my job and I knew enough not to cause anyone any bodily harm! Let me just tell you that it is GOOD that you have a fear of failure. It is important to be a little bit apprehensive when you are starting out in this field, even as a student. The ones that think they know it all are the ones that screw up big time. You be careful, and learn what you need to learn. The confidence will come later. A day in the life of an RN --- get a job in a hospital or start clinicals and get immersed. You'll find out what we really do soon enough. Best wishes to you.

What's a HDU? It is pretty standard in the US that ICU patients are 1:2 these days. There is a post right now on the home page that asks this question as well that you might want to look at (re: ICU staffing and what makes a 1:1.) Most hospitals have some sort of patient acuity decision making tree or something to determine who gets 1:1 care, and generally it is only the unstable patients. It is not impossible to take care of two ventilated patients with sedation on board and wrist restraints. It happens all the time. We do occasionally have self-extubations (but doesn't everybody?) Some patients tolerate the vent better than others and don't need chemical or physical restraints, as I'm sure you know -- it somewhat depends on the patient. I don't know how you are set up, either, but most ICUs in the US are set up with either glass doors or open bays where you can visualize the patients from most areas on the unit. This helps us keep tabs on everything as well. If you actually have a room with a door with an ICU patient in it, I could see that it wouldn't work very well to have another one down the hall. We also have a central monitoring station and we can set our monitors in patient rooms up to view another patient if we need to. As far as MD coverage, I would say most hospitals have either a resident or a hospitalist in house for emergencies at all times, overnight, etc. There are some small rural hospitals that do not and you actually have to call someone in if you need something. I don't feel that is really safe, but yes, that happens too.

Well, I hope she's mixing it sterile. The Dakins website also says that it's only stable for 7 days once opened so I hope she's dumping it after awhile.