linguine

Since you seem interested in long term career growth, maybe you could ask questions of the staff regarding their level of involvement in the GI department. These questions could give you some good insight to how your career may start and continue to grow there or not: -Do the staff there participate in GI-related continuing education? -Are you encouraged to attend GI conferences? -Is it possible develop GI-related projects [i.e. research project] in addition to the basic functions of the job? -Is your job limited strictly to the procedure aspect of GI or can you also float to the clinic if you need more variety? A follow up question if those answers are "yes" may be "when?".. Do they allow you administrative day to do those activities.. or do you squeeze the in between cases? etc. The current staff should be able to answer these questions. Regarding your concern about hospital GI being stressful: I would see if anesthesia [MD, CRNA] do the anesthesia, the GI doctors do it or if the RNs do it. This responsibility could be the most stressful part if the RNs are responsible for administering sedation if you are not experienced, in my opinion! Hope this helped. good luck!

I just finished a book, "Quiet: the Power of Introvert in a World That Can't Stop Talking" by Susan Cain, an ex wall street lawyer. She said "1/3 to 1/2 of people are introverts." She discusses the benefits of being "quiet" in your personal and professional life. One natural benefit is that introverts think more before they speak. Reading a lot of the posts above, it seems that a lot of the introverts in this thread say that they naturally do this, supporting her research. Introverts are also more comfortable following their intuition and are less risk averse. Warren Buffet is an introvert. Some argue that his nature helped him gather and KEEP so much wealth. She recently wrote an article, "The New Groupthink" noting how work spaces are now shifting towards more open office plans (first thing I thought of: busy, loud nursing stations). She does not support this shift necessarily. She does provide alternative plans. A lot of her suggestions can be implemented in health care. Her article in NYT can be found here: http://www.nytimes.com/2012/01/15/opinion/sunday/the-rise-of-the-new-groupthink.html?pagewanted=all Her TED talk, if you do not want to read the book, is a good introduction: What some may interpret as your weakness may actually be your best strength (this goes for introverts and extroverts).

Isn't this already occurring in some areas? So do you see this as a possibility and hope for growth of the NP role then? OP, I see some of your points but agree with some who mention that NPs have a vital role in health care right now. Politics is creating a system where in order to now serve the larger population, we need creative solutions and not rigid beliefs such as ones that assume only MDs can provide medical care. MD schools are tough to get into because of politics and not so much the lack of qualified individuals. The lingering argument is NP education standards. Regarding this, the governing boards seems aware of the need to create stricter and more universal training tools for the NP role. The solution for this is already on the table, though some may not agree with it (DNP, NP residencies, curriculum overhaul, etc.) Do NPs go to less school? It Depends. What defines schooling nowadays anyway? These days, what you learn is not limited to the confines of a brick and mortar institution. The role of NP is evolving quickly. Which way it evolves will determine the health care quality in the future.

Thank you for those insights. Flavored anesthesia masks? Never knew they had these.

hello periop nurses, I am hoping that some nurses on here may have some tips for pediatric perioperative nursing? I have never worked with peds in any setting (under 18) and understand there are certain developmental issues to consider to be successful in peds periop. I am preparing for peds specific challenges in the OR. Thank you, all the advice I've read have been helpful.

haha, I remember during my OB rotation, the nurse was working hard to coach the woman through her breathing while the baby was crowning. I felt a little helpless and just kept saying "almost there, I see the head!" I kept repeating this multiple times before the baby came all the way out. I reflected back on this, thinking how irritating that must have been for her and I should have just been silent. the deep breathing is great

Hi all, I work in an urgent care clinic and many times, patients come in requiring short procedures (minor burn management, wound care). I am wondering, from your personal experiences (maybe even as a patient), what are some strategies to help your patients cope with short term, acute pain? I suppose the strategies vary by population too. Give them directions? ("take deep breaths") Try to talk to them about something irrelevant? (I am bad at doing this because I can't focus on a conversation while performing a procedure very well.....) When I am getting my blood drawn (painful, but sort of nerve wrecking still) or having wound care done, I prefer not say anything so I can go to my happy place. What do you prefer?

It could prepare for working in the ER. The hospital interviews I have been too have asked if I were interested in the ER because of the triage experience in urgent care.

http://www.hrsa.gov/loanscholarships/repayment/nursing/ 2011 round ended but 2012 may be coming up if the gov renews the program.

Nursing schools are getting expensive. College overall is getting expensive and an average income has not risen much to compensate for the rising costs. Have you considered the federal loan forgiveness program for nurses? It helps pay some of your loans back if you dedicate to working at an underserved facility (it will be a challenge to find a job first.. but these could be in rural areas where not much new grads may look). Good luck, you are not alone! The nursing program I went to did not offer any scholarships and most classmates borrowed heavy loans for the education.

During the week that you work 12s, does that mean you work fewer days? (3 days vs 5) or do you still work 5 days and count any hours over 12 as overtime?

Hello or RNs, Do you mind sharing what a work schedule is like for OR nurses at your facility? From what I have learned so far, it seems that OR nurses generally work every day, start early in the day and end early. Is it dependent on the region (perhaps ruled by state mandates) or facility-specific? I wanted to get a clearer assessment of the varying schedules there are in OR nursing (including what it is like being on call, PRN, etc.). Thanks!

Hello periop nurses, Is there any way to follow up with patients after their procedures? I see how the surgeons could do this but what about a nurse? As a nurse in a clinic setting, I follow up with all patients that I triage and send home if thir issue does not need to be addressed by a provider that same day (because simply, demand exceeds supply). This follow up helps me determine whether the interventions I provided at the time were helpful or non-helpful. One reason I like primary care is the long term relationship with patients. Will this ability be lost working in the perioperative setting? I think I will enjoy most aspects of the OR but I want to be able to follow up with patients too and see how they are recovering from surgery. Any Insights? Thank you!

Hi Skipbeat, I am in a similar situation such as yours except I am coming from another specialty. I signed up for a periop 101 to help with the transition. Some hospitals offer OR fellowships which experienced and non-experienced nurses can sign up for. It is usually a one year long OR training program. Are you willing to relocate?

Nursing is a humanitarian service. Studying the humanities, whether in school or outside of school, is a good prerequisite for any human service profession.

Hello! I work in outpatient and we have been seeing many cases come back MRSA+ (and these are only the cases that the providers attempted to culture.) Patients are given Bactrim as a first line treatment if MRSA is suspected. While in the hospitals, isolation is much easier, how do we prevent the spread of infection in the outpatient setting? Right now, the protocol is hand hygiene (no gowns necessary) and to lysol-wipe the entire room once a MRSA+ (or suspected) patient leaves. We also routinely wipe down common areas routinely throughout the day, but this routine is not patient dependent but rather time dependent (on the hour, q2 hour, etc..) We also provide patient education to help patients decrease the chance of spreading an active infection to those they have close contact with. Any nurses work in outpatient who experience a similar challenge in how to prevent spread of infection in an outpatient setting? Thank you for your input!

In a community clinic, nurses are responsible many times for triaging and be comfortable with sometimes sending people home sometimes based on your assessments and nursing interventions because not all providers will be able to see the patient that day due to scheduling (nor do they have do see a provider for everything). RNs have the opportunity there to be good at initial physical assessments and history taking... a headache here could really be related to anything, minor or the beginning or a serious acute or chronic illness. Continuinity of care becomes crucial here as many diagnosis are missed the first time until the patient starts coming in a few times with similaer or worsening symptoms and things are starting to look suspsicious. Another challenge is the sheer volume of patients and personalities you will need to accomodate and serve every day and often. Triage nurses can experience an increase of acutely ill patients on Monday or Friday afternoons (or anyday of the week). If you are comfortable with those aspects of clinic nursing (which I think are the hardest), then it is a good opportunity. You do learn a lot about medicine and what is going on in the community.

Originally poster, it has been a year! any luck? I hope you are at your new OR job now!

Hello nurses! Has anyone worked in peds and adult periop before and able to compare the two? It might be facility dependent but I am curious as to what the differences are from first hand experience and insight.

Johns Hopkins SON has a BSN-MSN with a paid clinical residency (can google the program, not sure if allnurses let us link to schools websites.) According to the website, new grads complete the BSN portion, then do a paid, full time nurse residency for one year at the hospital or affiliates before starting the MSN portion. The clinical residency seems to be a new addition, perhaps in response to the new grad nurse job shortage.

If you want to pursue further education, especially research, it may be beneficial to keep the GPA high, usually whatever graduating with honors is at the nursing school. For a nursing job, it might not matter currently for all workplaces. However, many new grad residencies require a certain GPA to apply and this may become the norm.

From what I have learned so far: Physician residencies are subsidized by the US Department of Health and Human services. Taxpayers pay for medical residencies. Teaching hospitals also receive an incentive to train physicians. WildcatFanRN, I agree about the time constraint a new grad has in which they need to find a nurse residency before the one year mark. If nurse residencies became mandatory, schools may feel more pressure to ensure that their students match into a residency program to keep the schools reputation up and profits coming. If this were to suddenly happen, you may see a decrease in the size of enrollment and perhaps a decrease in the nursing glut we face temporarily. Possible benefits of nurse residencies : more new nurses who are more clinically prepared for a career. encourages hard work in school in order to get a good placement based on merit. encourages professionalism and growth. retention in jobs. more unison within the nursing profession through teaching/training. There are downsides as well; cost, increases competition in school (which ,arguably, is not always a bad thing)

Many primary care centers have a urgent care service provided along side with it. Depending on the day, you may rotate through the services. As mentioned in the above posts, the responsibilities include preventative care for the healthy, managing urgent care patients and managing patients with chronic care. You will likely get a lot of experience with triaging and practice your physical assessments and history taking. Patients are on many medications for various diagnoses so you will learn those too. Many urgent care centers treat their patients on site, with IVs and the works. Primary care and urgent care are challenging due to the variety of illnesses you have to recognize and the need for nurses to determine priority (triage): is this acute? do they have to go to a ER? chronic? what has/hasn't been working if it is chronic? Dieseases in the larger community tunnel through the urgent care and primary care clinics: influenza cases, STIs, mental health, etc., so you learn a lot about the community you are providing service to. goodluck with your job search

The main challenge of working in a clinic or medical office is the traffic of patients every day. At my workplace, the nurses alone have to triage 20-40 patients a day (not including the ones through phone triage) because the supply of providers cannot meet the demand for that day. The second challenge is that high traffic volume also means constant infection control. This practice must be done before/after every patient times however many rooms and public spaces there are in the clinic. In an OR or ICU, infection control is especially important but mainly confined to that room and that one patient. less traffic, less chances for spread of infection. In a clinic, every ill (and healthy) is a potential carrier of disease into the clinic as well as back out to the community when they are done with the appointment. I got sick pretty often during my first few months there but hopefully this means my immune system is stronger for it.

How will we practice to prevent inactive MRSA colonizations from becoming active and causing severe illness? This discussion reminds me Tuberculosis.... many are latent, but when it becomes active, it is a serious life threatening illness. Tuberculosis strains are also developing resistance to antibiotics now. For patients with latent TB infections, we advise: good hygiene, good nutrition and clean living conditions. With tuberculosis, a latent infection is very difficult, if at all possible, to pass to others. However, with MRSA colonization, it is easier for individuals to pass colonization even if the person is not having active infection. The recipient will become colonized and if immunocompromised at some point (perhaps even from a bad case of flu), can turn into an active infection.