All Content by FLoat RN
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BAD Preceptor, HELP!
Here is the simple solution! Tell your educator what's going on. They may set you up with another preceptor. Move quickly! Every day of your internship is precious.
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Uncontrolled DMI, when is patient "in trouble"
You should let the endocrinologist know what's going on. Sugars in the 800's or 30's can be lethal.
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Big scholarship to a nursing school for fall '11, not sure I want to attend. Advice?
I'm not sure where you got your information about 100% job security. You should check your sources. Hospitals are cutting back big time. They are not really even hiring new grads any more. Enter nursing because it's your passion, not for job security. It's probably one of the most stressful jobs available. You have peoples lives in your hands. You administer extremely dangerous drugs and procedures. The responsibility of practicing nursing is tremendous.
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New NP
I'm in ARNP school right now. I have shadowed a Primary Doctor in the Past. One thing I noticed is he did move very fast and efficiently because he was only addressing one problem and he knew what the diagnosis and treatments were immediately. He would go to each room very quickly order labs or simple point of care test, then go to the next patient while the blood was being draw or test being run. Yes you have to be fast yet attentive to the patient and their needs. It's a business and the physician may not be reimbursed as much as he/she charges. If the patient bring up another problem then they need to set another appointment.
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Make Advanced Practice Nurses Independent
Let me correct my statement I should have have said something along the lines of a pt complaint. I wasn't referring to lab results or vital signs. For example, i had a pt that was complaining of pain. I noticed that the nurse from the prior shifts were administering two tabs of Darvocet N-100, which contains 1300 mg of tylenol! By the time I had her she had over 3200 my of tylenol in less than 24hrs (This pt had a history of hepatitis). I called the Dr. and reported this. He just said give her what pain medication she is not allergic to. This example is not that rare. I'm sorry if I offended you that was not my intention. I was replying to the entry before mine. I don't think floor nurses should diagnose pt symptoms or lab results. However, I was always under the impression that NP do. I am agreeing with the article that more authority should be given to NP. The original article states ,"For years advanced practice nurses — as well as a host of other caregivers such as chiropractors and physical therapists —have butted heads with doctors over "scope of practice" considerations. Doctors maintain that even with an advanced degree, these nurses do not have the same education that physicians get in medical school and residency programs and that patient safety could be compromised. They are also wary that their practices could see significant patient losses if the nurses were allowed to practice more independently."
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By the time I am 30 years old =(
First of all, is English your first language? Regardless if it is or isn't, I believe you need to read more. You need to read a lot more. While you're reading you need to look up words you don't know and use them in a sentence. A runner never wins a race by only running when he or she needs to. Another thing you need to consider is your ability to understand English grammar. I struggled with the subject of reading and writing for many years during my childhood. It wasn't until I relearned the rules of grammar did I begin to retain information. Let me leave you with some questions. What's a demonstrative? Think of an example. What's a preposition? Think of an example. What's an adverb? Think of an example. In a sentence what's the subject? What's the predicate?
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Interview tips and tricks
They must preform interviews differently in Australia. I think in the US they assume you know the basics of the profession if you have passed your boards. However, I did have to take a medication math exam. In order to keep the job applicants had to score over 85%. It required a lot of knowledge of pharmacology. The main concern of employers in the US is experience and attitude. Don't sit in front of the individual interviewing you and dictate to them all your terms and conditions. Also ask the interviewer questions related to the position you are interested in. For example, What is the nurse to patient ratio? What are the expectations of nurses on your floor? Ask these questions if the employer ask you if you have any questions. It will make you seem interested not pushy and demanding.
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Make Advanced Practice Nurses Independent
The fact of the matter nurses are already more directly involved in pt healthcare than many physicians. How many times have you called a physician with results and they asked you what do you want to do about it? So you just tell him or her what you think and they just say yes to your orders. Nurses need more authority. However, I believe nursing school needs to be more difficult and more involved with pathophysiology, diagnosis, pharmacology and treatments. I plan on going to NP school fall 2011. I looked over the courses and I could tell it was just a bunch of fluff. NP school should resemble PA school. PA school is more like medical school.
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I made a medication error.
I think first of all you need to figure out whether you made a medication error or not. Elderly people usually have several comorbidities. Remember to always check vital signs before giving BP med or HR meds. Figure out if the pt is symptomatic. A BP of 86/53 really is not that low. You need to determine first if the BP was taken properly with the right size cuff. Often times CNAs don't measure the BP correctly with the right size cuff. If the pt is thin they probably need a pediatric cuff. In the case of a low BP you can place the pt in trendelenbergs. Also you need to monitor the urine output. If you have less that 30cc/hr that's an indication that you do not have proper kidney perfusion. If you maintain the MAP above 60 you have good organ perfusion. Another thing you need to take into consideration is the pt's trends. Has their BP been on the low side or is this new?
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Looking for RN's who have experienced a downsizing or a reorganization
In the state of Florida we do not have nurses unions; which I believe is our saving grace. The organization I work for is a not for profit hospital system. A lot of the nurses I know have part time jobs at other hospitals to make up for the fact that we no longer have any overtime available. I've always been under the impression that nursing has it's peaks and valley's just like other professions. I predict that as jobs become unavailable for gradate nurses nursing schools will go at off business. Then in ten years or so there will be a huge demand yet not enough new nurses to supply that demand. Then we'll see those huge sign on bonuses and overtime available.
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Starting arnp school 2011 how can i specialize.
I agree with you about the FNP degree. I am going to see what I can do about preforming my clinical hours in the ER. Thank you very much for your input. I'll looking into the CD you recommended.
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"Nurses Are So Mean"
I'm a float nurse so I'm almost always the new nurse. I believe that as a newcomer I need to try harder to get the approval of the people I work with. I'm treated fairly most of the time. Every once in a blue moon there is that one person who has a chip on their shoulder or perhaps just doesn't like me very much. That person I try to assault them with kindness. I try to make them feel comfortable. I offer to help them when I can. Eventually their walls crumble when they get to know me. This is something I've had to practice over and over again because I have a young pretty face. Never judge a book by it's cover. And never judge the people you work with because one day that person may be your boss.
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NP in a free clinic setting
Kudos to all of you for your hard work and dedication.
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Starting arnp school 2011 how can i specialize.
Ok I have one year of acute care nursing under my belt. I am planning to start my MSN next fall at a private university. They offer adult and family track for ARNP. Does anyone know how I can specialize once I'm done? I want to specialize in either ER, OR or ICU. I also intend on continuing to work as an RN for the next 2 to three years while I attend school full time.
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Advice for new nurses
Most importantly you should always remember to ask questions. Ask question! Ask questions! Even as an experienced nurse I will get the opinions of the nurses around me and consult reference material if I'm not sure about something. Yes it may take more time to search for the right answer however it's the safe thing to do. Safety first. And never forget your abcs and Maslow's hierarchy of needs. That's how you will know how to organize your day. Remember haste makes waste! Always double/triple check yourself!
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Need advise about ARNP grad school.
Thank you for the comment. I will do more research on the topic of DNP requirement in the state of Florida.
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Need advise about ARNP grad school.
Hello, I'm searching for some advise about applying to the right graduate school. I am interested in pursuing a career as a nurse practitioner. However, I have a few concerns. Please help. The college I am interested is the University of Tampa. They have a masters program available for adult care nurse practitioner, which is a two year program. Unfortunately the State of Florida now requires for ARNP's to have a doctorate. UT offers a bridge program through Case Western. I am concerned that UT might not maintain their relationship with case western long enough for me to get my doctorate. I am going to speak with a UT advisor this week and get some more information. Also, is a 1200 on the GRE a competitive score? I'm scoring in the 1200's on my practice test. Soon I will be taking a review course through Kaplan testprep. If anyone who's been through the application process would like to adopt me as a pet project please do. I would rather learn from other people then through trial and error. Thank you so much, LK
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Looking for RN's who have experienced a downsizing or a reorganization
What exactly do mean by downsizing and restructuring the staffing? I feel like my hospital is downsizing unintentionally. We have over 900 beds and our census has been in the range of 400 to 500 patients. I reside in the state of Florida. We rely heavily on seasonal tourism as the life source of our economy. The unemployment rate in the city I live in is about 13%. That's much higher than the national average. The busy season for the hospital was supposed to start about a month ago. We are still just as slow as we have been during our slowest season. The only thing I see the hospital doing is eliminating positions for cnas, transporters, and secretaries.
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UCLA MECN Fall 2011
Everyone loves the story of "Underdog" who triumphs over adversity. I think you need to broaden your definition of "socially disadvantage." What were your struggles? What gave you the strength and determination to become the success that stands before us today? Be creative! Illustrate to the reader that you are this phoenix raising from the ashes. Show the reader that you are a courageous person who possesses character and fortitude. UCLA is not looking for the run of the mill cookie cutter person. They threw this question at you because they want to see if you're a creative person. Please don't make your statement sound like a sob story. Don't victimize yourself. Be positive. Show them that you're a hero in your own way. Be positive. Provide example.
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Nurses, have you been been spit on, pushed, scratched and verbally or assaulted?
Now that aid is considered a felon. Physically assaulting a healthcare professional is a felony.
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Which floor is best to work in if you plan on going back to school
I'm a float nurse so have have experience on all different types of floors. There are several nurses on our float team that were ICU nurses at some point. They've mentioned to me that they prefer med surg to ICU. From my experience the amount of free time an RN might have on their hands depends on the patient ratio and type of patient. For example, sometimes I work on a cancer floor and their patient ration is typically 4 to 5 patients per nurse. However, this probably depends on the hospital as well as the individual policies of each floor. Sometimes I work at a women's hospital on a Med Surg gyn floor and their patient to nurse ration is 4 to 5 as well. These patients tend to be even less work then the caner patients because they tend to me much healthier. The patient ratio on most med surg floors at night can range any where from 6 to 7 patients. When you have that many patients you are usually too busy to even eat.