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akulahawkRN ADN, RN, EMT-P

Emergency Department

Wee bit about me!

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akulahawkRN has 6 years experience as a ADN, RN, EMT-P and specializes in Emergency Department.

I have approximately 20 years experience doing patient care in some form or another, finding along the way that Nursing has been calling me about 10 of those years. I consider myself fortunate that I am now able to answer that call. I hold a Bachelor's in Sports Medicine and now proudly hold an ASN. I feel lucky to have found a position in the ED, a position I have long desired and I enjoy every minute of it.

Got a license to learn! 

Had around 3k "likes" before the new format...

akulahawkRN's Latest Activity

  1. akulahawkRN

    How can I learn to be "rougher" with patients

    Well, there is a certain level of necessary roughness needed but you have to know when to be a little more "rough" and when to be more "delicate." Clearly when pericare needs to be done, more "delicate" is needed. Sometimes that necessary roughness is firmly anchoring an arm while quickly but delicately placing an IV line. Learning this doesn't take forever but it isn't learned overnight either.
  2. akulahawkRN

    SCC/ARC Fall 2021 Sac City/American River College

    If the phlebotomy cert was necessary to get you over the 70 points, then that's stressful indeed! If you're already over 70 points without the phlebotomy cert, then not so much... My case was almost similar in that I also had coursework from other colleges and universities, some more than 25 years ago, with name and course catalog number changes. I had to show the entire line of changes across the catalogs to get credit for the past courses. Tedious, but it worked in getting me the past credit needed.
  3. akulahawkRN

    SCC/ARC Fall 2021 Sac City/American River College

    When I was accepted by SCC (way back once upon a time, nearly 10 years ago now), I got an acceptance and a rejection letter. Needless to say that was a bit confusing but I did verify that the acceptance letter was the correct correspondence and the rest is history. Just know that the two programs (SCC and ARC) are fairly similar, so if you're "qualified" to attend one, you're very highly likely "qualified" to attend the other, assuming you've done everything needed to get in.
  4. akulahawkRN

    Infection after Vaccination?

    Let me see: ~7,200 "breakthrough" cases out of ~87,000,000. Roughly 500 hospitalizations and roughly 90 deaths out of ~87,000,000. Looks to me like the vaccines are working quite well.
  5. akulahawkRN

    Infection after Vaccination?

    Something else to look into is how soon after the 1st shot did a person develop symptoms. The closer one is to that 1st shot, the less protective the vaccine is. The closer one is to the 2nd shot, the more protective that first vaccine is. Another consideration is that during the surge times, we were sending people home that we'd usually admit, admission criteria was pretty strict. So, it's also possible that admission criteria may have relaxed a bit as well since the surge has generally abated. Since it is possible for partially vaccinated people (and even fully vaccinated too) to become infected and develop symptoms, and that we're seeing higher numbers of partially and fully vaccinated people now, we're going to see an increase in the percentage of people that have received at least one vaccine shot get hospitalized, even if the overall number of COVID19 positive patients that are admitted remain relatively stable. Since we've also vaccinated a lot of older people, we're seeing the shift in infected people toward a younger demographic. At my hospital, we're still seeing some elderly people get admitted with COVID19 but most of those haven't been vaccinated, but I'm just not seeing large numbers of them. I'm seeing only 1 or 2 per day (if that) where we used to see more like 10.
  6. akulahawkRN

    Did I pass NCLEX?

    Be very careful with this one... you must be ready to pay for and schedule a new exam in full. The "old" PVT wouldn't let you get to the payment screen if you passed. The current method is ready to charge your card before you find out if you've likely passed or not. If the State has issued you a permanent license, (no TEMP numbers) then you have passed. Mine doesn't do things quite like that and they're not often super fast about it. I was lucky, I got my license about 36 hours after I took the NCLEX. Other classmates had to wait longer, a week or longer in some cases.
  7. akulahawkRN

    Denial Letter , Crushed and Depressed

    I was qualified as an applicant every time I applied to nursing school and it took me YEARS to get in. Every season I was rejected, instead of getting down on things, I just continued refreshing my prerequisites, taking classwork to improve my own knowledge, and continuing to study for the placement exam. Eventually I got in, got through school and found a job. It is discouraging every time you get one of those notifications, but you get to choose to continue on or give up and do something else. It's up to you which way you go.
  8. akulahawkRN

    Bad Clinical Experience Today

    I have been advocating for better kits, unfortunately this falls on generally deaf ears. Therefore I must do the best I can with what I have. We're neither a community nor a critical access hospital. We just don't have certain services in-house, oncology being one of them.
  9. akulahawkRN

    ADN or BSN?

    I would normally suggest that if you have the opportunity to do either BSN/ABSN or ADN, you should go for the BSN/ABSN option because you would generally have greater employment possibilities. However if your only option (or acceptance) happens to be an ADN program, take it. You can do BSN later.
  10. akulahawkRN

    Bad Clinical Experience Today

    Actually, I do know how to access these ports. The port access kits we have aren't all that good and we don't get many port patients, so there's no impetus to get better kits. Guess what? Not all hospitals have an Oncology unit. Mine doesn't. I don't have access to that resource. Also, because I do know how to properly access a port, it really doesn't take me long to access and have it ready to go. So, not always is a "fear of infection" based on unfamiliarity. It can be based on recognition that the kits, while they can get the job done, aren't conducive to sterile placement and that it can be easy to inadvertently cause infection. Any other reason to slam someone you don't know?
  11. akulahawkRN

    SCC/ARC Fall 2021 Sac City/American River College

    SCC may or may not update your online status, but if you got an email stating what your status is, that's how you'll know if you got in, didn't get in, or are an alternate. They might update everything much later, but... they also might not. Usually they'll just update to "application received" and that's about it.
  12. akulahawkRN

    SCC/ARC Fall 2021 Sac City/American River College

    They likely will finish sending out their acceptance emails later today if they haven't sent them all out yesterday. They're only going to send out something like 60-ish letters of acceptance. COVID 19 may have reduced this number temporarily. They also do select their "alternates" and those notifications should also go out shortly, if they haven't already sent them. The video on their website says that "all students will be notified of their status" so you'll likely get a reject letter if you weren't selected. They do NOT have a waiting list and alternates aren't guaranteed a seat as far as I'm aware. Being an alternate is pretty much the worst status because you're in a limbo status and you have to be ready to accept and do stuff at a moment's notice... I graduated from that program and I've applied many times before I got in. I was almost always notified about 7 weeks after close of the filing period. This is that week.
  13. akulahawkRN

    Bad Clinical Experience Today

    Over the coming years, you will meet many people like those you met during your last day on that floor. There will be some great people to work with, both as co-workers and as patients and there will be some really horrible people too. The thing to remember is that you need to know what you're comfortable with, what you're willing to tolerate, and what you're not going to tolerate at all. When you have good, firm boundaries, you'll be amazed how quickly the toxic people stop trying to bother you because they realize that they can't bother you. As to the IV starts, there will also be people that just don't tolerate pain at all and will scream, wiggle, shout, and the like from something that is usually a relatively minimal painful thing. It's a natural reaction to withdraw from pain. It's a self-preservation thing. However we can learn to tolerate certain amounts of it or tolerate pain when we know it is for a short period of time or for a specific purpose. Don't get too enamored of the idea that ICU nurses are fantastic at doing things like IV starts. I'm an ED RN. I do IV starts (usually) several times a day on multiple patients and I used to be an active Paramedic. I've done this particular task for years. I really am that good. There are times that even I can't get a line. At my facility, I'm also ultrasound PIV trained and I usually can get those in one stick. It's very much true that even the most experienced of us can have trouble getting a line. I had a patient the other night that despite every trick in the book (and some that probably aren't), I just couldn't get IV access. You were, however, given a great piece of education on your last day. You were presented a challenge that you felt you couldn't meet. You successfully said that you aren't comfortable with doing that particular task. It's often a difficult thing to say "no" (and even do it gracefully) when you're in a student/orientee/junior role. That's a huge thing to learn that you can do it. Now I will say that when you have a chemo patient that has an implanted port, it is a clue that they're a difficult stick but they're not always a difficult stick. With port patients, I prefer NOT to access the port unless I absolutely MUST. There's just much that can go wrong and infection is just for starters. I've placed many a peripheral line in these patients. The key thing is to look and look, and look, and look, and look before you commit to doing the puncture. When I'm doing USGPIV's, I tell my patients that I will look and look and will NOT poke them unless I see something that I feel confident about. Same goes for regular IV lines. I had a difficult stick patient a couple nights ago and looked around a LOT until I found a vein that would likely work the first time. It was small but viable. I got it in one stick. I'm also not "married" to a given IV catheter size. I'll reach for an 18g or a 24g or anything in-between if it suits the need. These days I most commonly place 20g and 22g lines but I also happily place 18g as the need arises. Don't worry: you'll find your stride in this in due time. Seriously, the biggest lesson often ends up learning to say "no."
  14. akulahawkRN

    SCC/ARC Fall 2021 Sac City/American River College

    I think this is the week that were going to be seeing the acceptance letters from SCC. I suspect that the acceptance letters will be among the first letters to go out, probably around Thursday I think the other letters will go out. Knowing how they do things, I think we will have all of the letters out circulating amongst all the applicants by Saturday. ARC I believe follows a similar schedule. Good luck to all!
  15. akulahawkRN

    Struggling! LPN School

    You have a LOT of great advice here! Those of us that are in the field all still remember what it was like when we were in school. I can't stress enough SELF CARE and how important it is. If you don't take care of yourself and you try to simply power through everything, you will become slowly more and more mentally exhausted and you will slowly burn out and become unsafe while in clinical time, if not in other areas of life outside of school. I know. If you can, take a 30-45 minute nap (no more than that) right when you get home. The above advice is correct: it helps reset your brain and makes you much more able to learn more. More of a nap than that and you will upset your sleep cycle too much and you'll just wake up tired instead of energized. If you don't understand a term, use Google or some other reference and learn what it is. Also, don't be too hard on yourself. (Again, SELF CARE!) Everyone in your cohort is going through the same kinds of problems at some level. This is because nobody has likely ever seen this info before and it's all new to them. Find a few people to hang out with and study with, lean on them and allow them to lean on you for support. It will help! Your cohort will become your school family and you'll have friendships that will last a very, very long time. I was a Paramedic and Athletic Trainer before going into nursing. Even with all that knowledge, I had a hard time because nursing theory is just different from medical stuff. I worked full time, went to school full time, and raised a family. I didn't get straight A's, but that wasn't my goal. If I'd gone for the goal of straight A's, I would have failed. Instead, I went for as much balance as I could get. I graduated nursing school with honors. It is possible. Believe in yourself and believe that you can do it because it is possible and you'll amaze yourself when you look back at what you have accomplished. I still can't believe I did all that...
  16. akulahawkRN

    thinking of doing a phelbotomy course and wanted opinions

    Phlebotomy certification won't likely help you all that much outside the phlebotomy field. However, there is exactly one area that doing phlebotomy will help you with and that's learning how to find veins by feel because there are a LOT of people that have reasonably decent veins but you can't see them all that well, but they're palpable. The technique of accessing veins for blood draw and the technique of placing a peripheral IV are actually different. I've experienced first-hand. With a blood draw, all you really need to do is get the bevel into the vein. With an IV start, you have to get the bevel and the end of the catheter into the vein before you can thread the catheter into the vein. Just 2mm can make the difference between simply drawing blood and being able to place an IV. Where I work, I have the luxury of having phlebotomists available so I don't usually have to do my own blood draws. On the other hand, I also have the ability to do ultrasound guided IVs which is a cross between doing peripheral IVs and a video game... Anyway, the point is, if you're planning to do phlebotomy work, get the phlebotomy cert. Peripheral IV training will teach you much of the same mechanics but geared toward IV placement and the only benefit of phleb training is learning to feel veins if you're eventually going to start placing lines.