nsti

Hi, starting school in July, thanks for posting this! I was wondering if there is anything you wish you had studied before you started your program? Any professional organizations I should consider joining that are anesthesia related? How do they see the job market looking when you graduate? Appreciate the response.

To the person doing cvicu feel free to pm me, I oriented there

no the Foley teams cover the entire hospital no one on the unit does them

Congratulations on your offer! I have to say, I have been at Mayo for a few months and I really like it! Is there such a thing as over resourced? We ate VERY well staffed. I have not got out late ever so far. On my unit it is few and far between to pair patients, and only if they are very stable are they paired. They have a team to do labs ( including hourly blood sugars), a team to.put I've and Foleys, there is usually an ancillary and always an out of ratio charge nurse, etc. I have felt well compensated and well supported thus far. CONS: if you love autonomy, this is not the place for you. You may feel like you are losing skills because of all the teams. You definitely are expected more to present the assessment and limited recommendations in comparison to other facilities. There is definitely a Mayo way of doing things that people from other facilities might balk at. However, I have trusted the doctors, I have never had to beg them to put in an order or anything. They are VERY prompt and attentive, so that their orders make sense. I personally feel my license is far safer here. A small thing is there is no parking during the day at all, so be prepared to commute..However, if you live in town Mayo pays for the bus for you and there are shuttles also. Honestly the job is great. The town itself is less exciting, if you're single there is less to do, but it's a great place to raise a family. Bottom line is this is the best nursing job out there, hands down. I have had a few so I speak with some authority.

I did the VALOR program after my first year of nursing school. To answer your question, yes, there is a ton of paperwork. I do feel like the experience is more than worth it. In the competitive environment that new grad nurses are coming into, the nurse extern experience gave me the ability to get the job I wanted after graduation. I was on a med surg tele floor and it was all nursing responsibilities. They pick often from the VALOR pool for new grad RNS, but it will depend on the needs of the hospital l ended up in ICU at my VA because spots were open. The pay is nice, and I was able to act as a tech per diem whenever I wanted after I finished my VALOR. However, do not assume that because you got the VALOR they will offer you the job you want after graduation. Also, I ultimately ended up leaving the VA and staying there per diem after two years. I thought the program was the best step into nursing I could have ever had, though.

Hey, I'm an experienced RN looming into Rush, can you tell me how much experience you had when applying?

I am really not picky about which hospital, although I think Rush would be great. I'm just concerned about there being a glut of qualified experienced rns for icu jobs

I am looking to stat in icu in a decent hospital, preferably one that does trauma. That's more my concern. Anyone with insight into that?

Hello, I am looking to relocate to Chicago and was wondering if it would be difficult for me to find a job. When I start applying, I will have two and a half years' experience working in a mixed ICU with 19 beds, but it is not a trauma center. However, we do open hearts, IABP, ventricular assist devices, stroke center, neuro w/ventrich drains; pretty much everything except trauma and CRRT. I am wondering where the best areas to apply into would be, as I know most other hospitals have specialty units. I have my BSN, would be more than happy to go back for my MSN, and plan on being CCRN certified as well as getting the TNCC and PALS certs on top of my ACLS and BLS. I am also leaving the government possibly for the private sector. Please let me know what you think!

I interviewed as a new grad coming into ICU, but had experience at that particular hospital as a nurse intern and was asked the same questions as the experienced RNs. They asked me a handful of scenario-based questions. They want to know if you can critically think. My questions were pretty basic: MI, A-fib w/RVR treatment, stroke management, etc.

I'm of mixed heritage, and not like Heinz 57 mixed, I mean rainbow coalition mixed. I grew up with Turks, African-Americans, and Asians. I'm from Chicago, so I spent time with everyone from everywhere you can think of. Every time I read one of those stupid cultural competence sections, none of it was intuitive to me, because NONE of it seemed accurate. I talked to a variety of my friends and family about the various stereotypes paraded in those chapters, and all of them agreed how ridiculous they were. I wouldn't be terrible offended about them not mentioning Caucasians, because at least that saves Caucasians from the insult of being stereotyped. Personally, I think an excellent way to teach cultural competence would be to make nursing students volunteer in communities with people from a different culture. For example, I really wanted to go spend time on the reservations around my school, as in Arizona there are tons of Native American communities with a rich cultural heritage to learn from. They had cancelled the rotation because people in previous semesters had felt "uncomfortable" in that community, and none of my classmates or I could convince the instructors to change it. We need to throw our nursing students into uncomfortable situations, how else will they be competent with dealing with other cultures when they are afraid of them? Long story short, teach nursing students to use a culturally competent approach, and NOT to assume anything about anyone, and that is how they will become excellent nurses. You should always be asking your patients questions to assess what they want from their treatment.

AwesomeManRN, you are definitely right about the MRI; to be frank, we were all well aware that the code had caused the seizures. hte MRI was for the family, they still wanted everything done for the patient. I was questioning the MRI because if EEG are clinically diagnostic for brain death, why would they not be enough in this instance? It was even clear to me as a new grad that there was little brain activity other than the seizures, as between the burst activity, there was absolutely no movement on the EEG. As for why therapeutic hypothermia was not performed, I think there were two reasons. The stated consideration was his hemodynamic instability. I think sadly the main reason is that prior to the code he was immobile, about to receive a feeding tube and unable to swallow, etc. I think the MDs just didn't feel it was an appropriate allocation of resources. Being a government hospital, this is a major consideration. Honestly, I think that it was unlikely that he would have regained consciousness even with TH.

Hello! So I am a recently graduated RN working in a MSICU, and I deal with pretty much everything under the sun, but I figured this would be more appropriate as a neuro ICU thread. I had a pt who was found unresponsive on the MS floor, coded, and was brought up to our units. He had not woken up at all after the code. We had him intubated and sedated and whatnot, and we noticed some seizure-like activity that was going on pretty much continuously. We got him all hooked up to the EEG and saw the seizures. I was wondering if the correct order of meds was really being given, as the MD was saying start propofol and get Ativan on board as a temporary measure until we could get Dilantin up froim pharmacy. We got all that on board and it was stopping the majority of the motor activity portion of the seizure but not the activity on the EEG. We even had started him on Levo because we had such a high rate of propofol going (Per the MD, he was up to around 100 mcgs). Even when we gave the Dilantin bolus he continued to show activity on the monitor and slight motor tremors. We moved to a Versed gtt, and titrated up on the Versed to more than the max than myself or the orienting nurse were acquainted with. The EEG tech and the neurologist stated that the ideal would be if we could see less than 3 bursts of activity on the monitor per minute, and we were nowhere close to that. The MD moved to the next step as a pentobarb coma, at which point it was the end of my shift so I didn't really get to see any resolution. The neurologist wanted an MRI to say with certainty that anoxic brain injury was the cause, but with the pt showing little response to any meds we didn't end up taking him down. This gentleman had no prior seizure hx, but did had end-stage Parkinson's. Anoxic brain injury was pretty much what the critical care MDs believed the seizures were coming from. My question is, was there other meds that we could have been giving that would have been more effective? Is there any other course of tx that you experienced neuro RNs feel would have been more efficient? I felt like a fish out of water being new, and my orienting RN was also a bit lost because she had not used EEG monitoring as a baseline to titrate seizure meds. I'm hoping you guys will be able to give me a bit more info!

I don't know about any transferring as I went straight into the hospital that I worked in. I would assume so but then again with the VA you never know things slip through the cracks

I will say that Kaplan worked really well for me, because the Qbank shows you how to answer questions the "NCLEX" way. It's expensive, but worth it. They also have a PDF that you can download. I used Saunders to review. Every practice test that I did, I went through all of the rationales, right or wrong. If I got the question wrong because I didn't know the content, I went to Saunders to review the topic. I would say that other NCLEX study methods are good for content, but Kaplan made me feel like I knew how to answer the questions. It helps that the online tests look like the NCLEX, so when I was taking the test it felt like I was sitting at home doing Kaplan.