SookeyRN

Any good bachelor's program emphasizes evidence-based practice - of which nursing research is a basic element (I don't know about ADN programs) . If not for nursing research (NOT medical research) we might still be doing things the way Florence Nightingale did them - just because "that's the way we've always done it".

I don't mean to sound picky, but I did want to point out that CHOA, Crawford Long, Wesley Woods are all part of the Emory Healthcare System. :) Also, if you have a parent that works at Emory (I guess that's not very likely, though), Emory forgives part of the tuition depending on how long the parent has worked there. I think that if a parent has worked there 10 years (at any Emory facility) that the entire tuition is paid by Emory.

I'm at Emory as a Chemo nurse - the commute for me isn't too bad - about 45 minutes in the AM and an hour on PMs, but parking is a pain (my second day I got a $35 ticket), and the pay is fairly well below Atlanta averages (mine is an RN III OCN position). Emory is a top-notch teaching facility for physicians, but I was surprised when I went to work there that there were no nursing students to precept. They must all do their internships/preceptorships on inpatient units. I graduated from Iowa, so I have no idea about educational opportunities in Atlanta (except that Emory is too rich for the salary they pay me) Paula A Diet Pepsi gal in a Coca-Cola world!!

I don't know if this is even a problem, or if I am making more of this than it really is. I have worked on my unit for a year and a half now, working 60% (24 hours a week), and attending graduate school full-time to obtain my NP in adult/gero with emphasis in oncology and palliative care. I had a short orientation to my unit, because I did my last-semester internship of 245 clinical hours on that unit. My six-month evaluation came and went and I was doing very well, and I got an excellent evaluation at my one-year evaluation in July. Of course there were a couple of errors I'd made over time - forgetting to unclamp a med (NOT unusual - I can't tell you how many times I've followed the previous shift and found meds still clamped), not signing out a medication (but I had given the med), or once I missed an order when I red-lined. I also recently obtained my OCN certification from the Oncology Nursing Society (only two other RNs on my unit have their certification). So a couple of weeks ago I had one day, a Saturday, (which was only an 8-hour day) where I had to give platelets to one patient, two units of blood to another, and Mag and K to even another patient. When I received report, I thought it was pretty busy, but I could handle it, no problem. Well, in the meantime, labs came back for my platelet patient, and he needed two units of PRBCs. The physician decided that the first patient who needed two units also needed 75 gm of albumin and lasix in between units, and my platelet/2 units PRBC patient ended up having an ENT consult/ct with contrast/possible move to MICU due to risk of airway loss. I knew that in this 8-hour day, and with my level of experience, I could not complete all this, and that perhaps I should trade out a patient with one of the other nurses who only had 2 patients and was mostly sitting around. I was told by one of the more experienced nurses that nobody could, and to not worry, that we're open 24/7, and to take it easy. I come in on Monday and my NM wants to speak with me. My patient with possible airway compromise did not get an abx and steroid that had been ordered. I had transcribed the order, and had even called the pharmacy twice wondering where the drugs were. As it turns out, the order never got sent to pharmacy as it didn't get torn out and sent. During the week, our unit pharmacist checks the orders, tears them out and sends them. This was a weekend day and I didn't realize the order hadn't been torn out and sent. So I got written up for this error (she said I should have traded out one of those patients - DOH!!) and now she wants me to have a "resource person" to go to when I work. I follow people all the time who haven't taken off orders from day shift and left it for the night shift, or meds haven't been run, things aren't signed out, etc. I fix them and go on. When I started this job, I was told to pick my battles, and most of the time it wasn't worth it. I told my NM that I felt like I have a target on my back all of a sudden - that I did not suddenly, in the last couple of months, become incompetent and need remedial training. I just can't figure out what is happening here. Any thoughts? ============================ Every man is guilty of all the good he didn't do. --Voltaire

As someone who is extremely sensitive to smells myself (scents are a very sensitive migraine trigger for me), and having been taught not to, it is just plain common sense to not wear perfumes and strong-smelling lotions/body sprays when providing patient care. I work in BMT, where CINV and gut GVH is a problem, and some chemotherapies (carmustine, for example) cross the blood brain barrier and affect the CTZ area of the brain. That said, I think it would be wise to always remember that YOUR favorite scent may not be the favorite scent of the people around you. My mother-in-law wears White Diamonds, and insists on wearing it when she travels in the car with us - which honestly makes me quite ill (hmmm....maybe that's why she wears it?? ).

What I remember from what little legal we had as seniors in undergrad, if you stop to give aid, you are expected to perform at at least minimal standards within your scope of practice. As long as you have done that, you cannot be held liable for any wrongdoing. This assumes you are a licensed practitioner and know your scope of practice.

I work on a 14-bed inpatient BMT unit. I started there a year ago right after graduating. If we have patients who need a vent (doesn't happen very often), they're transferred to the MICU, then transferred back when the vent is no longer needed. The most intimidating thing for me has been trying to organize the IV meds and administering blood products at the same time. I used to really stress about getting all my meds hung exactly on time and trying to work in giving platelets and PRBCs, and was running myself ragged trying to do it with 3 patients each day. I've been there a year now, and it has gotten easier. I'm still learning, of course, but once I figured out that those once-daily drugs or once-weekly drugs don't HAVE to be given exactly on time, and that CVN can be stopped long enough to run an 8-pack of platelets, my life got a LOT easier! The suggestions so far I would agree with - learn the difference between antivirals, antifungals, and antibiotics, and make sure your physical assessment skills (especially listening to lung sounds) are fine-tuned. :) Paula

Hi Joyce! I don't have any real answers for you, except to say that I plan on taking the OCN certification this fall, also. I took an oncology specialty elective my last semester of my undergraduate program at Iowa, and have been working on a 14-bed inpatient BMT unit for the last year since getting licensed. I work with several RNs who have taken the OCN Certification exam, some of them have worked in oncology for more than 20 years. They have advised me to take the OCN review course offered through the local ONS chapter, saying they found it extremely helpful (only because BMT is so highly specialized and the OCN exam covers all types of cancers and oncology nursing). That said, if you don't have that much exposure to oncology, I wondered if you might not meet the qualifications to take the OCN certification exam, which includes at least one year of oncology experience or 1000 practice hours in the 30 months prior to applying to sit for the exam, and 1.0 oncology-specific CEUs or 10 contact hours. The actual qualifications are listed here at http://www.oncc.org/getcertified/TestInformation/ocn/eligibility.shtml Good luck! Paula

Hmmm...I don't remember saying "fast recovery" anywhere.

If the stroke is embolic and is less than 3 hours old, tPA can be used to dissolve the clot. Function does return quite quickly as blood flow is restored to the watershed areas (hers was in the temporal area, where the speech centers lie). The tissues have not been deprived of vital oxygen long enough to cause tissue breakdown or permanent damage. This is the logic behind getting treatment for a stroke ASAP and not waiting - the damage can be reversed easily if treatment is begun before tissue breakdown occurs, but if it has been longer than 3 hours, the tPA treatment is said to be of little value. An aneurysmal stroke is not treated in the same fashion, however. The moment there is bleeding into brain tissue, there is damage to neurons from the pressure of the bleeding (Munro-Kelly Hypothesis), and toxins (cytokines, etc) created by the inflammation. :) Paula

Let us know!!! {{{{SDcowgirl}}}} SookeyRN (or pkallen61 after name change)

:balloons: :balloons: congratulations!!! :balloons: :balloons:

Sending tons of good thoughts your way. This isn't a "therapeutic communication" (and focuses on *me* instead of *you*):stone , however, I felt the same exact feeling when I took the exam on Monday (6/21). I was fine until the computer shut off - that's when the anxiety started. That 48 hour wait seemed like it lasted a lifetime. You have my thoughts and prayers.

:balloons: CONGRATULATIONS!!! :balloons:

i changed my sign in name - but had to do a whole new account to do it (changed from pkallen61 to sookeyrn after finding out this morning that i passed).:chuckle