LMPhilbric

What kinds of bad things have you been hearing? I just graduated from USA and I am very happy with the program. Now the ACNP program, from what I hear, is extremely intensive. The booklist will be published on the South Alabama College of Nursing website. Look under the current students tab and you will see booklist. It won't be updated yet b/c there is a summer semester first. Go ahead and PM me if you want to discuss which profs to select. Please let me know how I can help, Linda

First, with the 5 year-old, that was in 1939, so I would question the accuracy of her age. I've had many people from rural Latin America who have no idea when their birthdays are or how old they are, so I would say it's entirely possible that she could be 8 or 9 or older. Especially in places like Guatemala, the women are teeny. I had a 30 year-old lady who came up just past my waist (I'm only 5'4"). She had 3 children and my co-workers were wondering where her mom was because she looked like she was 12. Granted the child in the pic is still way too young to be bearing children of her own, but it could be common in rural parts of Central America in the early 20th century. My best nursing home patient...she was sent in at 7:30 PM to have her PICC line replaced after it was pulled out by accident at 10 AM! I called them and told the NH that the PICC department was open from 8-4 and they needed to call back during regular business hours to make an appt. I also asked how they managed to give the 2 PM dose of IV antibiotic (which was signed off on the MAR they sent) when she had no IV access. There was dead silence then the nurse told me "Well, I don't know. That happened on the previous shift". I also wanted to know why no one thought to address this problem earlier in the day, such as shortly after it happened! Still, no good answer. I placed a teeny tiny 22 in her hand and sent her back so they could give her meds. Duh!

I'm at South Alabama in the ER Nurse Practitioner Program. I finish in 26 days (not that I'm counting). It's an excellent program and I'm very happy w/ it, but the ED program is transitioning somewhat right now. They are going to a dual FNP/ACNP program and so the clinical hours are increasing and I'm not exactly sure what areas you will have to complete clinicals in for that program. There are around 11 different specialities so you can have your pick. Each program is different, but the ENP program requires us to go to Mobile once a year. We stay for about a week and it was a blast. You can't put 30 ER nurses together and not have fun. It was also a great learning experience. If you have any questions, please feel free to message me.

I forgot one of my all time favorite dumb orders. We had a pt admitted for a TURP. Doc comes in and writes his usual pre-op orders. 1) Senekot S 2 tabs po at hs. 2) Tap water enema in AM. 3) Bilateral below TED hose. Great orders with the exception of the fact that this pt had bilateral BKAs. We were debating whether we should send the prostheses to the OR with the stockings on or what. The OR nurses read the order and ripped the doc apart all during the surgery. Poor doc couldn't get out of the hospital without passing through our ward. We were lying in wait for him. We started peppering him with questions like "What is the incidence of DVT in wooden legs?" He couldn't get out of there fast enough.

OK, I'm laughing so damn hard right now my dogs are looking at me with alarm (both females, I'm happily married so they don't have to worry...lol). What the hell could you possibly be thinking when you do something like this? And the best part of this is that I know every single nurse in my ER would be more worried about the dog's outcome than the stupid human! It's not like the dog had a whole hell of a lot of choice in the matter.

What did I get out of getting my BN? Interesting question. The primary reason I got my BN was so that I could get my MSN as an NP. However, I did learn interesting things along the way that I didn't get to learn in nursing school (I was a diploma prepared grad for 17 years before I got my BN). My diploma program was very focused, so I had to take the courses that were required by the program and nothing else. I took them in the order indicated and all of the courses were very nursing focused (eg. nursing, psych, A&P, micro, etc.). In my BN, I got to take a variety of electives including law, forensic psychology, history, genetics, etc. It was fun to study something for the pure joy of learning. In my nursing classes, I had a great class in informatics, another in health assessment that is serving me very well as I do Advanced Assessment for my Master's. I also took Gerontology and (I can't believe I'm saying this), research that were very interesting. Did I learn anything specific that made me a better bedside nurse? Yes, in the assessment course. Other than that, specificially know, but there is a critical thinking that comes with the undergrad program that does indirectly affect your care. The leadership part of the program helps you see different perspectives in the running of a unit, so that is useful as well. I would recommend a BN just because it does open up doors. The satisfaction that comes with completing a Bachelor's degree is immense, and it gave me a tremendous. It gives you the opportunity to continue on to grad school, gives chances to teach or to lead if you choose that you won't get with an ADN. I think we will eventually go to a Bachelor's degree for entry to practice, but I don't think it will be soon (although, Ontario and British Columbia, I believe, have made the BN the entry to practice degree). There are many options now for obtaining a BSN from part-time, to internet options, so explore your options and if you want to go for it, do so! You can start out by taking one class at a time to see how it works for you combining work, school and family. I have chosen to do my degrees by distance ed, but it isn't for everyone, and please don't ever think that distance ed is somehow "easier" than a "real" school. Distance ed requires a tremendous amount of self-discipline and organization, but it does give you more freedom when it comes to scheduling. Whatever you choose to do, good luck!

My all time favorite dumbest order ever written...We had this pt in ICU who had just expired when the doc walked in. As we were trying to explain to him what had just happened, this doc walks in, does his "assessment", compliments the pt on how cool his eyebrows look, and that he seems to be doing much better (this would be the dead guy). He proceeds to come up and write a whole bunch of orders including ABGs, US GB, etc. All the while, the nurses are trying to get a word in edgewise to this weirdo who is making grizzly bear and ambulances noises to tell him that the pt is dead! Finally, one of the other docs grabs him by the shoulders, and yells "Your patient is dead!". The doc looks up, says, "Well, I guess we don't need the ABGs then", leaves the rest of the orders as written, and takes off. Everyone just kind of stood there staring at the door after he left, unsure of what to do. He was the same doc who went into the dictation room when there were a bunch of student nurses standing in the nurses station. He let out this blood curdling scream, and then stepped out of the room and looked around trying to figure out who screamed. These poor kids were never right after that. We told them, "Don't worry. It's just Dr. So-and-So, and if you ever hear a bear behind you, don't worry. You're not going to get eaten. It's just him". True story, I swear!

Better give him the whole freaking tree at that point. And we let these people reproduce...it's really frightening.

I had one from the same doc for metoprolol 25 mg IVP and Lovenox 40 mg IVP. I said "Let's not try to finish the patient off all at once, shall we?" Try po and sc. The only time we did IV Lovenox was during a clinical trial (that mustn't have been too successful because I don't see them doing it anymore). This doc's last name started with "Kell". We used to call the doc "Kill" because of her stupid orders.

I would have an awful lot of hs sugars around 114 in that case.

Did he work as an executioner somewhere before????

My #1 rule of engagement: If you are bigger than I am and land on the floor, you stay there. I don't pick up anything bigger than I am. I also love the ones who have "anaphylaxis" from Tylenol, but they can take Lortab or Percocet. Is it really such a bad thing to call someone a liar to his or her face?

Huh? After the ER???? After I leave the ER, I'm going to retire. OK, I'll be honest. I'm in school to be an Emergency Nurse Practitioner, but I'm still going to be in the ER. I'm never leaving the ER. I'm not going back to the floor, I'm not going to Endo to look up people's butts all day, LTC is totally out (so I can send NH dumps to the ER on NH Dump Day????), Case Management??? I almost ate a CM for dinner one night when she got in my face at the wrong time. The deal is that I love patients. I tried administration, hated it. I really, really miss my patients when I'm away from them. I would like to teach, but it's the same thing...not enough pt contact. Yep, if you want out of the ER, then you should definitely go. If you don't love it, it's the wrong place for you.

Admit for 200?????!!!!!!! We would have a full house year round. 200 in my ER is a total lightweight. We hold them until the BAC is under 300 if they have a sober friend or they get a ride to the Hoosegow for the night. Under 80 they can walk. Honestly, the *only* patient I have ever admitted for alcohol intoxication had a BAC (I swear on my great-grandma's motorcyle) of 596. He drank 2 bottles of Haitian rum inside 10 minutes in a suicide attempt. He was tubed and vented. I had another one that was 576 walking and talking. We had to hold him for almost 12 hrs to sober him up to the point where he could get a ride with the po-po to the jail. I completely agree with not letting them get too low. Over 300 walking and talking is a serious alcoholic and they will start to DT within 2-6 hours depending on how hardcore they are. You wait too long and they will seize. I call the cops when I have about an hour left before they're below 300 so I can get them off to the jail before they do the funky chicken on me.

That is so true. We often refer to our hospital as the Ritz Carlton Hospital when we get someone who wants 1000 thread count sheets on their stretcher or some other such ridiculous demands. "Pardon me, while I stop the CPR that I'm doing so that I can freshen your water for you while you wait to be seen for your toothache."