LittleOneRN

I was a new grad when I started LTAC and going on my fourth year. The type of patient has a general stay of greater than 25 days; ventilator dependent and sedated; some other drips that require hemodynamic monitoring such as levophed, amiodarone, etc. The goal is to wean them off the vent. You also have wounds that require intensive treatment; all patients need PT/OT etc for strengthening as they are debilitated. Typical day is extremely busy; I have had as many as 3 vents at once or as many as 6 wounds at once. GREAT place to get diverse skills: central line, trach, PEG, identification of dysrhythmias. Not for the faint of heart, you are pooped at the end of your shift. I had a 3 month orientation with close support - if they do not offer this, I would be careful. As a new grad, you have a lot to learn and will be given great responsibilities.

I am so, so sorry for your loss. I was in a similar situation a few years ago, and had the discharge nurse write the name of the drugs given to me on the discharge papers. I took it with me to the Occ. Health clinic and they made a copy of it. I never heard back about a positive test and was hired by the facility.

The Arkansas State Board of Nursing just had a comment about this. In a nutshell, the AACN recommended the DNP by 2015, but without statutory changes (no state has it yet), then it will not be enforced. DNP programs are growing, so I would say the wind is blowing in the DNP direction . ARSBN: ASBN Update Select November 2010, page 13

I worked full-time and went to school part-time on-line through Oklahoma Wesleyan. I have family, but found it to be generally doable. They do not have a traditional "clinical", but you have some significant projects in the final classes that require community interviews, etc. that make for the clinical component. It takes 18 months if your prerequisites are done prior to the start.

We started IV's on each other. Each student was (and still is as I understand) required to sign a waiver before the "event".

I recently clarified a similar order with a nephrologist. He responded in a condescending tone that he was quite aware of what the IV intake was as he ordered most of it, and that it (the order) is always considered oral intake I can't wait to call and clarify with him again in the future, just to make a point of a better order needed :)

What kind of unit do you work on? I work on an LTAC, and when census drops we get cancelled. How they go about fairly determining who is cancelled might be the issue you should consider. Those with call-ins get cancelled first. If the census continues to be low, then they rotate through the rest of us. Most use PTO to cover it or go without pay.

I agree with everything Altra said. It takes time. I used to have a similar reaction, and eventually realized that I, for whatever reason, felt totally responsible for the event, how it was performed, and the outcome. That is not reality as there is an entire team there, but that was how I felt. I have, through experience, realized that codes will happen regardless and many do not have good outcomes. I am responsible for doing my best. Find your trigger and deal with it!

I eat a serving of Yoplait yogurt, a half peanut butter sandwich (on wheat), and a Kashi pumpkin spice flax granola bar. The key is having protein as it sustains you longer than carbohydrates. The yogurt and peanut butter cover that, and the 4g of fiber in the Kashi bar helps with a feeling of fullness as it is slower to digest. I have a history of glucose drops, but this is the formula that works best for me. I usually last 6-7 hours before I feel hungry now!

Quarks work for me, and they are not terribly expense. I have plantar fascitis and this is one of the few shoes that does not aggravate it. The suggestion to change your shoes halfway through the shift is a good idea.

Get your BSN. I am finishing mine, and wish I had not waited this long. It is doable working full-time, but you pretty much lose your social life, especially those with kids that take priority. You will never regret it, and will be glad to have it some day as it may give you more options in the job market.

I do not understand your problem as you were vague, but if somebody has made statements that are hurting your chances in your occupation, you may have grounds to sue for defamation of character (slander).

Do not let this stand in your way. I fainted after a toenail extraction. It gets better with time/experience, and if I had bailed after that toenail so many years ago, I would have missed out on some of the most rewarding, wild, and humbling moments of my life. The best way to get back into the game is to do just that. Show up and get back into it. Your anxiety will ease with time, I promise. :)

A pain management physician once told me that abusers will "break" the time-release coating on pills by cutting them in order to get the rush of the narcotic all at once. I have no idea if this is what your patient wanted or he just had a different way of doing things.

I don't know if this helps, but at my facility if you do not get your CPR/ACLS by the time it expires, you are taken off the schedule until it is accomplished. You also cannot use PTO, so it is a pretty good incentive to get it done as you will be out of work without pay.