tmwilliams84

Thank you, my understanding that physicians felt it was not right for RNs to precribe medications and not have a doctorate. Maybe I am not well informed, but nursing is changing. I look forward to see the outcome, Is it because we don't have enough nursing leaders or is it more of a professional advancement demands on nursing? You tell me, we are also short in academia as well.

I would suggest an online MSN program,look on website www.bhrsa.gov. They may have a scholarship program for you. I hope this helps.

My issue is that nursing practice have come so far to go back. I feel that often we do not have enough leaders to speak up against lobbyist in regards to what goes on in "Our pratice." We have more of the traditional nurses, head bobbing like everything is peaches and pie. The reality is that doctors feel we need to have a DNP to prescribe medications for those of us advancing or is NP. Really, residents don't even know anything when they get out of school. Everything they learn is during their residency, yet some resident can pda a med just to give my patient some morphine or how about when I suggest to them what to prescribe. My issues is this we need to further our education not in terms of AMA lobbyists, but for us to be in control. If we had just as many nurses supporting us this will not take place. I don't think its fair for us to have to do something to satify the doctors just so that we can stay beneath them and not grow as our own profession. Once again we are moving backwards and not forward. Yes, I encourage all nurses interested in DNP to get it just not in terms of some political bullying! Tell me what you think.

Pain is number one sickle cell crisis, 8 out of 10 is very high. For t-max tylenol or ibuprofen is ok. Most sicle cell patients take toradol rt inflammation. This temperture will definitely send him into a crisis, so we need a pca pump. respitaory equipment, airway first. Also keep in mind there is a high probability for acute chest, blood transfusion or even echange which means more than one unit of blood given. Monitor vitals every 4hr, montior pain and response to pain medication closely. BP is low probable sepsis due to infection, antibiotics and hydration.Spleenomegaly can occur this is where the cell are broken down, chest xray to ro acute chest. Monitor cbc,retic and BMP. Patient low pressure due to low volume possible dehydration. Also how you can tell if a true sickle cell crisis is happening, look at the sclera of the eyes, bili and liver enzymes are elevated during crisis. Cold wheather, low hbg 7-8 is baseline and infection send them into crisis. I hope this helps! Tiana ONC RN