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NPOaftermidnight MSN, RN, NP

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NPOaftermidnight has 7 years experience as a MSN, RN, NP and specializes in Pediatrics.

NPOaftermidnight's Latest Activity

  1. NPOaftermidnight

    Silicon Valley/Bay Area NP jobs/salaries

    So I posted this on the California board bug hoping to reach a broader audience here! My family is moving to the Menlo Park area next month for my husband’s job. I’m an FNP currently working in pediatrics but I have adult experience as well so I’m looking at a variety of positions. Specifically, Stanford (including the Children’s hospital), Kaiser, a handful of private practices... just wondering if anyone had any suggestions on good places to work as well as what I can expect salary-wise... I’ve heard a huge range so I’m not sure what to actually expect. Thanks for your time!
  2. NPOaftermidnight

    Tele strips in ICU

    Every 8 hours
  3. NPOaftermidnight

    Can I work in OB/GYN as a FNP?

    Lots of FNPs work in women's health. You say you are just graduating nursing school, so you have plenty of time to get a little experience and see what you like first. The FNP will leave you with a lot more options than the WHNP degree. I know a couple with the latter, but they were very experienced L&D nurses who had never done anything else and would never have even considered another type of job.
  4. NPOaftermidnight

    Primary Care NPs rounding?

    I'm not sure why you worded your post like you did but I'm assuming you're asking how many FNP/AGNPs are employed in acute care? This is not uncommon in my hospital, a large academic medical center. I just graduated from an FNP program and have accepted a position here that is split between the clinic and the hospital.
  5. NPOaftermidnight

    Hurricane Irma and guilty conscience......help me!!

    If it doesn't work out, you will have opportunities for more jobs in the future. You only have one mother. You did the right thing. I would have made the same decision in a second and I hope that my daughter would as well. Good luck and stay safe!
  6. NPOaftermidnight

    Having issues with being a "babyfaced" nurse.

    I really don't think that your looking young is the main issue here. The patient was wrong to speak to you the way that she did, but this is going to happen. If the worst thing a patient does to you in your career is comment on how young you look, I would say you are in excellent shape. Perhaps this is something you are super self conscious about in your every day life, or maybe you are lacking confidence in your nursing skills - I don't know. You mentioned you are going to see a therapist, I think that is a great idea. Over your career, you are going to meet some really great people - focus on them. As far as the jerks, just go in, do your job, and get out. You can't let them get to you. I would also like to suggest the possibility that you are getting burnt out in your current position. Maybe it's time to try something new?
  7. I have used Haldol in the ICU (rarely) but never for these conditions.
  8. NPOaftermidnight

    Family videotaping patient care

    You handled the situation just fine. You can't win them all! Think of it as a blessing that you don't have to work with this family again - she did you a favor by firing you. And like someone else said - this doesn't negate the good care that you provided the patient. I have only been "fired" by a pt/family a couple times in my career, but each time it was like a huge weight had been lifted off my shoulders. As nurses we tend to want to make everyone happy, but it's not always possible. Sometimes you just have to cut your losses and move on to patients/families that WILL appreciate your care and expertise.
  9. NPOaftermidnight


    It has been a couple years since I took the exam, but I mainly used the Gasparis DVDs/book and I could have easily passed had I studied nothing else. I found it a lot easier than NCLEX, while the content is definitely more advanced, the questions are much more straightforward. It was a hard test, but a fair one. Keep doing practice questions whenever you can and you'll do great. Good luck!
  10. NPOaftermidnight

    Pushing metoprolol IV w/o tele..?

    I would absolutely not, regardless of the clinical picture. Your instincts were correct. In my hospital, even in the ICU, we only push metoprolol in an emergency (they must be on the monitor and a provider must push it). Otherwise, we mini bag it and give it over 15 but they ALWAYS have to be on the monitor. We had a patient die a couple years ago as a direct result of pushing metoprolol and this has been our policy ever since. I think it's a little extreme, but at least it's safe and I haven't seen any pts suffer as a result. Make sure you check your policy, and if it's not specifically addressed bring this up to shared governance or whoever is in charge of these things. If it is, in fact, common practice for metoprolol to be pushed on unmonitored pts in your institution, this is an accident/lawsuit waiting to happen. Always trust your instincts and never be afraid to say you aren't comfortable with something!
  11. NPOaftermidnight

    Female catheterization with possible retained tampon

    No. Women do NOT menstruate when pregnant (I can't believe I just typed out that sentence. On a nursing forum ). Can you have bleeding/spotting during pregnancy? Absolutely, but it is NOT menstruation and you should absolutely not be using a tampon. I feel like there is some major information missing from this story. Why do you suspect a retained tampon? Why was the patient using tampons? Why are you inserting a foley on POD 5? Why is the pt even still in the hospital on POD 5 of a csection? Clearly something has gone wrong here. However, regardless of the answers to these questions, you need to call up that provider and have them come do a pelvic as soon as possible. If I could see a string I would remove it, but a "vaginal sweep" is not something that I would feel comfortable with as an RN - just have the provider come do an exam with a speculum.
  12. NPOaftermidnight

    Ever refuse a follow-up?

    Why would you call and complain to their insurance??? Kissing/grabbing someone without their permission is a form of sexual assault. You could call local law enforcement and file charges. This goes beyond sexual harassment. Just curious, what kind of setting do you work in?
  13. NPOaftermidnight

    Not transferring transcripts due to bad grades?

    This is really, really bad advice. Your old transcripts certainly could hurt your chances, but you are obviously doing much better now and your current grades reflect your commitment. The schools will be MUCH more interested in your recent academic history than a few classes you screwed up when you were a kid. MANY people have rough patches in their transcripts, just be honest about it and be prepared to give a short explanation. Many college apps even have a section specifically for explaining poor past performance, so know you are not alone. Trying to hide these grades is literally the worst move you could make.
  14. NPOaftermidnight

    New grad struggles

    Have you talked to your manager about this at all? If you aren't meshing well with a particular preceptor, it is perfectly acceptable to let your boss know. This happens pretty frequently where I work and we always do our best to make good matches between preceptors and orientees. It is part of their job to ensure that you have a good orientation that gives you what you need to be successful. They want to see you succeed, so don't be afraid to let them know you're having a tough time. Also make sure, if you haven't already, to have a talk with your boss and your preceptors about your performance. Most ICUs will not sugar-coat it, if you aren't doing well they will let you know. They should already be doing this. Most importantly - if they tell you that you're doing well, believe them. It's normal (and actually, a good thing) to have some degree of fear and anxiety when you're brand new in the ICU. It's the fearless ones that we worry about! I don't know you, so I can't give you any really specific advice for your situation, but I will say that what you are describing sounds like the majority of new grads in the ICU at one point or another. I would encourage you to stick with it for a while longer before making any moves out of your unit.
  15. NPOaftermidnight

    Can I ask to work exclusively day shifts?

    Find out how the hospitals in your area are run. I'm surprised to see on here that so many do rotating shifts still. None of the hospitals in my area do these, if you apply and are hired for a day position then that's what you'll work (although it is usually easier to get hired on nights). It's totally not unreasonable to ask for one shift, single mom or not.
  16. NPOaftermidnight

    AMA discharges

    I agree with many others, I've never had a patient who left AMA who would have stuck around long enough for prescriptions. I'm not sure if we would give them or not, to be honest. I once had a patient leave AMA with a chest tube. That was interesting. I think he ended up back in the ED a couple days later.

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