picurn1972

You must decide for yourself. MD is straight thru with no breaks. My brothernlaw is an MD. I regret very much I didn't stay true to the path of MD in my youth. I am to old to work all night. Also, you must realize that as a resident you do 70 hours a week. and the pay is not much. If you are someone who is goal driven and always finishes a project regardless of the time then why not! Try to observe in a picu if that is what you want. Just remember the down side, these are the people who tell parents their children are gone. I have seen it happen to one doc 3x in one week. If you can't handle that then MD not a very good choice. Good luck!

This is PT based. An entire pole change out is required to let drips run thru tubing so it will mimic the same infusion on the other pole. We do this with 2 rn's scrubbing and reconnecting almost simultaneously. This prevents really sick babies, under 1 that are on crrt from coding. Other kids aren't as sensitive to these gtts, older kids, and you can change out to the same pumps by building the knew line and switching over. This is safe practice but once again clinical judgement. These kids have primary nurses on our unit and they know their patient. They know how they respond. Having worked with adults prior we never set up an extra pole just switched. You should have a standard guideline to building the line, we build on sterile drape attaching all gtts carrier and or med line. This is on a surface wiped with chlorahexadine wipes prior to the draping. No laundry cart, pt bed etc. Only bedside table or nurse server. This reduces cvc associated infections and has been found to be the best practice. Our facility has research and articles that support these steps. then you place new sterile drape at cvc site. Hope this helps. The pole/individual/pump issue should all be determined by the RN because the new pole set up is very time consuming and if it is not necessary the RN could be doing tasks that are more beneficial for the patient.

Get ready for resuscitaton on a whole new level, when your 16 yo is bleeding out from GI bleed!

I work in a level 1 peds icu and NP's do nothing but round with the fellows/attendings writing their orders. They make no decisions and do NO invasive procedures. Maybe it will change one day but not in top teaching facilities where these fellows need to gain vast experience to care for future sick kids. Only way in our city to d lots of procedures etc is NP in the adult worl. Sorry to dissapoint, but why on earth do 4 yrs bsn, and 3-4 years for NP considering youll need a doctorate to make only maybe 25% of that of the md. Don't forget the tme yull need to spend on the floor getting RN experience. Most reputable NP programs require at least 1 year. In addition thats 8-9 years, compared to 4 yrs premed 4 yr residency and 3 year fellowship 3 extra years to make an easy 300,000 more, not to mention the procedures, intubations, cdes etc. If you can handle it and want it go MD, it is what I advised my stepdaughter

i know 5 that passed in 75 in my class

aspiration pneumonia, and no pain at least 2 hour but don't cave b4 1 hr. It is the actual moving in and out that helps the most. Otherwise we,d put all of our beds into chair positions. A teenager should be pulling at least 500 to keep alveoli open especially with no belly pain or surgery. The teenager will only do what you make them, tough love. Also, I have only seen orders to IS, not volumes. Refer to average tidal volumes for pts of different ages/sizes. Hint 6-8 per kg should be the target for any age. Example 100 kg then 800 TV, or 50 kg 400 tv also remember these are larger breaths than normal so the goal of the IS should be above their average intake volume.

Find out what type of surgeries it is generally based on the level. My sicu was liver txp, kidney, big thoracic sur, and traumas. Call and ask them if they have info/education material. Is there a seperate cardiac icu? Then you will have a better idea on where to focus your studies.

dont you have to do totals every hour? Any doc sees the volume which is off the pump and knows how much the pt got. At least all our SICU attendings did. second in peds yes you chart the time of the bolus, but in adults you chart the score of the scale you used to bolus then a post assessment. How would you defend yourself in court without record of the symptoms/scores on which you based your bolus's. That is why you bolus and titrate up. Pts are stimulated every hour or two. Do you want to be intubated and be awake or appropriately sedated?

we stop tpn occasionaly for access issues your course of action was standard on our unit including the post about the D5 also know how fast you can givethe abx, some can be given in 15 minutes. Check with pharmacy and you might be surprised, however the mycins youll just have to wait

dont forget Protonix!!

In response to post. Husband is first, if no husband and children it is oldest child over 18, then diverts to parent of pt if none of the rest, never made it farther than that it is the law in our state. Yes the dnr includes any medications that are considered code meds including epinephrine. So stopping them is part of the DNR. Don't know about the verbal DNR. I would be extremely uncomfortable to initiate the DNR if the husband you spoke of had not signed the DNR form at your facility.

Let's see, crrt is 1250 just for the filter, apheresis tops out around 10,000 and people get it everyday for weeks at a time, yeah BMT docs keep pushing, then add the vent. and all the other costs. It is VERY variable on why you are there ie transplant surgery, BMT, Trauma, etc. One night for the room was almost 9000 where I worked that does not include fluids, blood, vent, etc. Don't know if this helps. IV fluids NS were 75$ and I was told they only cost under 1$ it compensates for all those who aren't insured.

Well I have 2 answers. I work with someone who scored that high and passed in 75 question. However certain scores are required to graduate on the hesi where im from. I on the other hand wasn't required to pass hesi to graduate it was only for information, so I didn't prepare. I did prepare for my nclex. Scored a whopping 480 on the hesi(horrible) passed the boards with 75 questions in 40 minutes. So I would say sometimes it does. Don't reallt think this helps and 2 be honest I remember many questions from nclex and I feel the were different like more drugs, etc on nclex

Don't you have a competency checklist of goals /skill that need to be acquired during orientation? Titrating drips, pressors sedation, bedside procedures? If you do tell them you need to focus on them, if not it wouldbe a great project for the future. Our orientation is no call offs, time depends on nurse as individual.

I think it depends. In my pursuit to work at one of the best peds facilities in the country I did use some personal and it was then that I got 3 interviews. That little cover letter is all the manager saw from a stack of similar resumes sent from HR. I'm not saying give details, but I mentioned personal experience with their facility and my goal and passion to work there because of these experiences, I think it can help set you apart in certain circumstances. Good Luck, the kids world likes it, family centered care and all Its wonderful and yes I did acute adult prior.